Abstract
Objectives: To determine the expression of CA-125 in stage I epithelial ovarian cancer patients by demographic and clinicopathologic factors. Methods: Data were obtained from the National Cancer Database (NCDB PUF 2016) between 2004 and 2015. CA-125 results were reported as abnormal if they were ≥35 Units/mL before treatment. The proportions of abnormal and normal CA-125 levels were compared between groups using Chi-square test. A multivariate logistic regression analysis was used to determine adjusted odds ratio (aOR) and 95% confidence interval (CI). Results: Of 14,912 patients with stage I epithelial ovarian cancer, the median age was 55 years (range 18-90). Whites, Hispanics, Asians and Blacks comprised 83.2%, 5.4%, 4.9%, and 4.5% respectively. Stage IA, IB, IC, and NOS were found in 49.9%, 4.9%, 41.1%, and 4.0% of patients, respectively. The distribution by histology included 36.1%, 24.5%, 19.9%, or 19.5% with endometrioid, serous, clear cell, or mucinous carcinoma and 24.2%, 20.6%, 45.5%, or 9.7% with grade 1, 2, 3, or missing, respectively. An elevated CA-125 level (≥35 Units/mL) was observed in 70.9% of stage I epithelial ovarian cancer patients. The proportion with elevated relative to normal CA-125 did not vary by age or race. A total of 71.4% of older patients (≥50 years) had abnormal CA-125 levels compared to 70.0% of the younger cohort (P=.085). 68.2%, 72.6%, 70.9% or 70.2% of Blacks, Asians, Whites or Hispanics had abnormal CA-125 levels, respectively (P=0.14). Black and Hispanic patients had higher proportions with missing or not tested CA-125 (36.1% and 31.6%) compared with 27.5% and 27.3% of Whites and Asians (P Download : Download high-res image (113KB) Download : Download full-size image Conclusions: Compared to Whites, Blacks and Hispanics were less likely to have CA-125 testing. Over 70% of patients with stage I epithelial ovarian cancer have elevated preoperative CA-125 levels. Women with mucinous and clear cell carcinoma, lower sub-stage, and grade 1 disease were more likely to have normal CA125 levels.
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