The utility of presurgical CA125 to predict optimal tumor cytoreduction of epithelial ovarian cancer

Abstract

The objective of this study was to evaluate the ability of a preoperative serum CA125 to predict whether optimal debulking (OD) could be achieved for patients with stage III and IV epithelial ovarian cancer (EOC). The records of consecutive patients who underwent primary surgery for EOC at Indiana University Hospital between January 1997 and January 2003 were reviewed. Eligibility criteria included FIGO stage III/IV disease, surgery by gynecologic oncology faculty, preoperative CA125, and an operative note clearly defining volume of residual disease. The Medcalc software statistical package was used to generate a receiver-operating characteristic (ROC) curve. Two hundred and eighty-nine cases of stage III/IV EOC were identified, of which 164 met the eligibility criteria. Serum CA125 </=400 was associated with OD >/=75% of the time. Conversely, OD was achieved in </=40% of patients with CA125 >/=4500. The area under the ROC curve for CA125 was .670. The OD rate for those with and without ascites was 49% and 79%, respectively (P < 0.001). In a multivariate analysis using CA125, age, and ascites, the area under the curve was 0.686. We conclude that preoperative serum CA125 did not reliably predict OD in patients with stage III-IV EOC.

Postoperative human epididymis protein 4 predicts primary therapy outcome in advanced epithelial ovarian cancer

“…Preoperative serum CA125 has been reported to correspond to PDS outcome 16,[30][31][32] although contradictory results have also been presented. 10,33 Perioperative CA125 changes have also been associated with PFS. 34 Our previous study focused on HE4 in NACT response evaluation.…”

Prognostic and predictive relevance of CA-125 at primary surgery of ovarian cancer

“…The role of perioperative CA-125 is not fully determined. Some authors could demonstrate a correlation between preoperative CA-125 and surgical outcome, but there have been conXicting results (Barlow et al 2006;Chi et al 2000;Vorgias et al 2009;Kang et al 2010). This study was designed to analyze the potential prognostic impact of CA-125 concentration before and after primary surgery as well as its perioperative variation in a large and homogeneous single-center cohort.…”

Prognostic Factors for Complete Debulking in First- and Second-Line Ovarian Cancer

“…The first one, from Gemer et al, 15 showed at a threshold of 400 U/mL an accuracy of 0.62, and the authors concluded that the clinical applicability is limited. Barlow et al 16 showed similar results at the cutoff of 400 U/mL. Two actual studies provided controversial results.…”