Cancer-associated serum antigen level: a novel prognostic indicator for survival in patients with recurrent ovarian carcinoma

Abstract

The aim was to examine the value of the pretherapeutic serum cancer-associated serum antigen (CASA) level as a prognostic factor for survival in patients with recurrent epithelial ovarian carcinoma. Serum levels of CASA and cancer antigen (CA)125 were prospectively determined in 70 consecutive patients with recurrent ovarian cancer before the start of second-line chemotherapy. Univariate and multivariate analyses of survival were performed. The median level of serum CASA was 6.5 U/mL (range: 0.2-1437 U/mL). Univariate analysis showed that patients with a CASA level >10.0 U/mL had significantly shorter survival than patients with CASA level < or =10.0 U/mL (P= 0.002). Using different CASA cutoff levels (6.0, 6.5, and 10.0 U/mL), multivariate Cox analyses identified CASA as an independent prognostic factor for survival at every cutoff level. The strongest prognostic function for CASA was found at a cutoff level of 10.0 U/mL (>10 vs < or =10 U/mL; hazard ratio, 2.7; 95% confidence interval, 1.6-4.7; P < 0.001). The pretreatment CA125 level was not found to be significantly associated with survival by any of the cutoffs (35, 65, 132, and 339 U/mL). A pretreatment elevated level of the tumor marker CASA is an adverse prognostic factor for survival in patients with ovarian cancer relapse.

Pre-Treatment Prediction of Chemoresistance in Second-Line Chemotherapy of Ovarian Carcinoma: Value of Serological Tumor Marker Determination (Tetranectin, YKL-40, CASA, CA 125)

“…The finding of CASA as a chemoresistance predictor in the present study might be explained by the presumption that ovarian cancer cells overexpressing CASA are more resistant to the effects of inflammatory cells and cytokines in the tumor microenvironment, but this hypothesis should be validated. In comparison, the median level of CASA in the present study (6.8 U/mL) is similar to that found in other series of patients with recurrent ovarian cancer (median 6.5 U/mL) (38).…”

Role of CA125 in predicting ovarian cancer survival - a review of the epidemiological literature

“…Another prospective study examined the value of pretherapeutic CA125 in 70 consecutive patients with recurrent ovarian cancer before the start of second-line chemotherapy. CA125 was not found to be significantly associated with survival by any of the cutoffs (35, 65, 132, and 339 U/mL) [ 39 ].…”

“…Of the eight studies reviewed under the relationship between prechemotherapy absolute serum CA125 levels and survival, four were prospective, one retrospective, one convenience sample, one consecutive case series type of study. Six studies [ 37 , 38 , 40 - 43 ] showed a highly significant relationship between prechemotherapy serum CA125 level changes and survival whereas one study [ 39 ] did not find such relationship. In one study, prechemotherapy CA125 was found to be strongly correlated with the probability of progression within 3 years but the data suggesting the relationship between prechemotherapy CA125 levels and survival was not provided [ 44 ].…”

Rising serum CA-125 levels within the normal range is strongly associated recurrence risk and survival of ovarian cancer

“…CA-125 is a tumor marker of ovarian cancer that plays a significant role in making clinical decisions. Many studies assessed the importance of a single CA-125 measurement [7][8][9][10][11][12][13], while number of studies that analyzed the multiple evaluation of this marker is limited. Conducting such studies is challenging, as they long term follow up, large number of variables and due to difficulties in interpretation of the data.…”