CA125 nadir concentration is an independent predictor of tumor recurrence in patients with ovarian cancer: A population-based study

Altena, Anne M. van; Kolwijck, Eva; Spanjer, Marielle J.B.; Hendriks, Jan C.M.; Massuger, Leon F.A.G.; Hullu, Joanne A. de

doi:10.1016/j.ygyno.2010.07.025

Cited by 42 publications

(31 citation statements)

References 24 publications

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“…Employing a clinical cutoff of >35U per mL [3, 5, 20, 21], serum CA125 levels were elevated in 86 of 88 patients diagnosed with EOC (P-value<0.0001, Fig. 1D; Table 1).…”

Section: Resultsmentioning

confidence: 99%

Prognostic analysis of invasive circulating tumor cells (iCTCs) in epithelial ovarian cancer

Pearl

Zhao

Yang

et al. 2014

Gynecologic Oncology

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Goals: Circulating tumor cells (CTCs) have been introduced as a biomarker in detecting advanced Epithelial Ovarian Cancer (EOC). The goals are to examine the prevalence of the invasive subpopulation of CTCs (iCTCs) in patients at high risk of EOC and to compare this biomarker to serum CA125. Methods: We used a unique Cell Adhesion Matrix (CAM)-based, functional cell enrichment and identification platform to isolate iCTCs from 129 preoperative patients. We confirmed the identity of iCTCs using positive epithelial (Epi+) markers and negative hematopoietic lineage (HL-) markers. Sensitivity and specificity of the assays were examined and iCTCs / CA125 were correlated with overall survival (OS), progression-free survival (PFS) and clinical parameters. Results: We found a 41.2% sensitivity, 95.1% specificity and 77.8% positive predictive value (PPV) of the iCTC assay in detecting patients with stage I and II EOC malignancy, and a 83% sensitivity and 97.3% PPV in detecting all stages of EOC malignancy. However, a positive CA125 test provided weak evidence to detect stage I and II malignancy (61.6% PPV) and all EOC (92.1% PPV), because of its 76.2% specificity. A significantly stronger concordance in OS and PFS of clinical factors (tumor stage, debulking and platinum sensitivity) was noted for elevated iCTCs than for serum CA125. Conclusion: The CAM-initiated CTC enrichment / identification method enabled the detection of early stage EOC. iCTCs were better correlated with worse OS and PFS, more specific and better PPV than CA125 in detecting EOC malignancy in patients at high risk of EOC.

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“…Employing a clinical cutoff of >35U per mL [3, 5, 20, 21], serum CA125 levels were elevated in 86 of 88 patients diagnosed with EOC (P-value<0.0001, Fig. 1D; Table 1).…”

Section: Resultsmentioning

confidence: 99%

Prognostic analysis of invasive circulating tumor cells (iCTCs) in epithelial ovarian cancer

Pearl

Zhao

Yang

et al. 2014

Gynecologic Oncology

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“…Following this, other groups have subsequently validated the concept that the CA-125 nadir after primary treatment of EOC may serve as a prognostic factor for PFS and OS, even though the patient population and the clinical setting differ notably amongst studies [34][35][36][37] (Table 2). Van Altena et al have recently reported the largest study (n=331) evaluating the CA-125 nadir after primary treatment and its potential association with both PFS and OS [38]. The CA-125 nadir was defi ned either as the fi rst measurement of CA-125 at least one month after the surgery, in patients not receiving CT, or the CA-125 value one month after the last CT course.…”

Section: Resultsmentioning

confidence: 99%

“…This association seems particularly signifi cant in those patients who have optimal debulking [44]. In addition, the lowest CA-125 value (CA-125 nadir) achieved after the primary treatment of EOC has consistently been associated with survival (PFS) outcome [33][34][35][36][37][38]. Again, if this observation could be validated by using prospective data sets from large phase III clinical trials, it may be worth further investigating if the CA-125 nadir levels could serve to stratify patients into different subgroups when designing future clinical trials in the adjuvant setting, especially from the perspective of maintenance or consolidation therapy strategies [45] (Fig.…”

Section: Resultsmentioning

confidence: 99%

Prognostic and predictive value of CA-125 in the primary treatment of epithelial ovarian cancer: potentials and pitfalls

et al. 2012

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The serum cancer antigen 125 (CA-125) remains a reliable biomarker in the therapeutic management of epithelial ovarian cancer (EOC). Monitoring the efficacy of cytotoxic chemotherapy (CT) and the early detection of relapse during the follow up of patients in remission represent the two most common clinical situations where the CA-125 has been successfully applied. There are however other scenarios along the course of the disease where the CA-125 can potentially aid in the decision-making process. Preoperative levels of CA-125 can help in selecting a subset of patients where an optimal cytoreduction may not be easily achieved. Perioperative variations in the CA- 125 levels after primary surgery and, more importantly, the nadir value of the CA-125 after primary chemotherapy, are associated with patient outcome. This review focuses on the clinical relevance of dynamic changes in CA-125 levels during the primary treatment of EOC and its potential influence both in the patient management and in the design of clinical trials in the adjuvant setting.

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“…13 A validation set was defined as ovarian cancer patients diagnosed in the other 7 hospitals, consisting of 316 patients in complete clinical remission after primary treatment. For these patients, mortality data were available, but mode of recurrence detection was not registered.…”

Section: Validationmentioning

confidence: 99%

Impact of Routine Follow-Up Examinations on Life Expectancy in Ovarian Cancer Patients: A Simulation Study

Geurts

Vegt

Altena

et al. 2012

Int J Gynecol Cancer

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CA125 nadir concentration is an independent predictor of tumor recurrence in patients with ovarian cancer: A population-based study

Cited by 42 publications

References 24 publications

Prognostic analysis of invasive circulating tumor cells (iCTCs) in epithelial ovarian cancer

Prognostic analysis of invasive circulating tumor cells (iCTCs) in epithelial ovarian cancer

Prognostic and predictive value of CA-125 in the primary treatment of epithelial ovarian cancer: potentials and pitfalls

Impact of Routine Follow-Up Examinations on Life Expectancy in Ovarian Cancer Patients: A Simulation Study

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