Abstract
BackgroundWe investigated the prognostic impact of changes in serum CA125 levels during the first 3 months of therapy in ovarian cancer.MethodsA case series of 170 ovarian cancer patients treated at Cancer Treatment Centers of America. Based on CA125 levels at baseline and 3 months, patients were classified into 4 groups: 1) Normal (0-35 U/ml) at baseline and three months; 2) High (>35 U/ml) at baseline, normal at three months; 3) Normal at baseline, high at 3 months; 4) High at baseline and three months. Kaplan Meier method was used to calculate survival across the 4 categories.ResultsOf 170 patients, 36 were newly diagnosed while 134 had received prior treatment. 25 had stage I disease at diagnosis, 15 stage II, 106 stage III and 14 stage IV. The median age at presentation was 54.2 years (range 23.1 - 82.5 years). At baseline, 31 patients had normal (0-35 U/ml) serum CA125 levels while 139 had high (>35 U/ml) levels. At 3 months, 59 had normal while 111 had high levels. Patients with a reduced CA125 at 3 months had a significantly better survival than those with increased CA125 at 3 months. Patients with normal values of CA125 at both baseline and 3 months had the best overall survival.ConclusionsThese data show that reduction in CA125 after 3 months of therapy is associated with better overall survival in ovarian cancer. Patients without a significant decline in CA125 after 3 months of therapy have a particularly poor prognosis.
Highlights
We investigated the prognostic impact of changes in serum CA125 levels during the first 3 months of therapy in ovarian cancer
Despite the achievements of high response rates with surgery followed by chemotherapy [5,6], 75% of women die of complications associated with disease progression
Studies show that the survival of early-stage disease is significantly higher than those with advanced cancers, approximately 20% to 30% of these patients will die of their disease [7,8,9]
Summary
We investigated the prognostic impact of changes in serum CA125 levels during the first 3 months of therapy in ovarian cancer. Ovarian cancer is the second most common gynecologic malignancy in the United States, with approximately 22,200 new cases each year [1]. The overall lifetime risk of developing ovarian cancer for women in the United States is 1.4% to 1.8%. This risk varies from 0.6% for women with no family history, at least three term pregnancies, and four or more years of oral contraceptive use, to 3.4% for nulliparous women with no oral contraceptive use. Ovarian cancer is often asymptomatic in its early stages and most patients have widespread disease at the time of diagnosis [4]. Mortality might be reduced if the disease is detected in the early stages [11]
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