High levels of pretreatment CA125 are associated to improved survival in high grade serous ovarian carcinoma

Abstract

BackgroundSerum levels of CA125 measured before any treatment have been evaluated in epithelial ovarian cancer (EOC) as a predictor of patient survival; however, results in survival index are controversial, as CA125 levels are influenced by several variables. Taking this into consideration, the present study evaluated the association of pretreatment levels of CA125 serum with the clinical stage, histology and differentiation grade of the tumor and the survival rate in a group of patients from an oncology referral center in Mexico, all of them diagnosed with ovarian carcinoma.This retrospective study consisted of 1009 patients with EOC, diagnosed between 2006 and 2013 at the National Cancerology Institute (Instituto Nacional de Cancerología-INCan), considering only those with CA125 measurements before any chemotherapy or surgical cytoreduction. Patients with three years of medical follow-up having pretreatment CA125 value and simultaneous diagnoses of histological subtype, clinical stage and differentiation grade of the tumor (n = 656) were studied in order to determine their survival rate.ResultsThe abnormal level (>35 U/mL) of CA125 was observed in 99 % of serous carcinoma cases rated I to IV in the FIGO stages. Abnormal CA125 proportions were 89 % in endometrioid subtype and 69 % in mucinous tumors, with the highest absolute value of CA125 observed in serous carcinoma surpassing any other histological subtype. Clinical stages III and IV displayed increased CA125 values compared to stages I and II. Undifferentiated carcinomas show the highest level of this indicator compared with those of low and moderate differentiated grade. Survival evaluation by Kaplan-Meier analysis including only high grade serous carcinoma at FIGO stage III (n = 57) demonstrated 57.1 % chances of survival in patients with CA125 pretreatment levels higher than 500 U/mL. Survival was 26.7 % in patients with CA125 lower than 500 U/mL and the hazard ratio for CA125 ≤ 500 U/mL was 2.28, 95 % CI 1.08–4.84, P = 0.032.ConclusionsClinical stage associated with pretreatment absolute values of CA125 should be considered as prognostic factor in EOC patients. Values of CA125 higher than 500 U/mL in high grade serous carcinoma with FIGO stage III resulted in an enhanced survival rate of the patients.

Emodin suppresses proliferation, migration and invasion in ovarian cancer cells by down regulating ILK in vitro and in vivo

“…Mice were randomized into two groups, and 200 μL re-suspended serum-free PBS with either 1.0×10 7 viable SK-OV-3/pLVX-Con or SK-OV-3/pLVX-ILK cells was injected into the right armpit of mice, according to their group allocation. The volume (V = [length × width 2 ]/2) of subcutaneous tumors was measured every other day. When tumor volume reached 100 mm 3 , each group of mice was randomized in two groups (n=6) to receive different treatments.…”

“… 1 The lack of effective early detective markers and pathognomonic clinical symptoms means that there is currently no effective technique for the routine screening of the population. 2 As a consequence, 80% of ovarian cancers are diagnosed at the advanced stages with widespread metastases. 3 The prevalence of metastasis arises from the poor prognosis of EOC and leads to high mortality rates.…”

The effect of CA125 on metastasis of ovarian cancer: old marker new function

“…Serum CA125 levels are routinely monitored in patients with ovarian cancer, and an increase from an individualized nadir concentration is a prognostic indicator of cancer recurrence. More than that, CA125 levels are useful indicators of the response to chemotherapy and disease relapse and progression [ 10 , 11 ].…”

The Clearance of Serum Human Epididymis Protein 4 Following Primary Cytoreductive Surgery for Ovarian Carcinoma

“…CA-125 is a good preoperative marker in postmenopausal women and in HGSC. 32 All HGSC cases in this series had elevation of both CA-125 and HE4 prior to treatment. The single CCC in this study had gross elevation of CA-125, but the HE4 level was less than 70 pmol/L.…”