Abstract
Objective:To assess the association between normal CA125 levels at diagnosis of epithelial ovarian carcinoma (EOC) with prognostic factors and with outcome.Methods:The study group consisted of histologically confirmed EOC patients with normal pretreatment CA125 levels, and the controls consisted of EOC patients with elevated (≥35 U/mL) pretreatment CA125 levels, diagnosed and treated between 1995 and 2112. Study and control group patients fulfilled the following criteria: 1) their pretreatment CA125 levels were assessed; 2) they had full standard primary treatment, i.e. cytoreductive surgery and cisplatin-based chemotherapy; and 3) they were followed every 2–4 months during the first two years and every 4–6 months thereafter.Results:Of 114 EOC patients who fulfilled the inclusion criteria, 22 (19.3%) had normal pretreatment CA125 levels. The control group consisted of the remaining 92 patients with ≥35 U/mL serum CA125 levels pretreatment. The proportion of patients with early-stage and low-grade disease, with optimal cytoreduction, and with platin-sensitive tumors was significantly higher in the study group than in the control group. The progression-free survival (PFS) and overall survival (OS) were significantly higher in the study group than in the control group on univariate analysis but not on multivariate analysis.Conclusion:It seems that a normal CA125 level at diagnosis in EOC may also be of prognostic significance for the individual patient.
Highlights
Based on the initial report by Bast et al.,[1] the serum level of 35 U/mL is considered as the cutoff point for CA125
Normal Pretreatment CA125 Levels in Ovarian Carcinoma. It seems that a normal CA125 level at diagnosis in epithelial ovarian cancer (EOC) may be of prognostic significance for the individual patient
Elevated CA125 levels are most common in patients with serous ovarian carcinoma (SOC), while the other types of EOC often present with normal serum CA125 levels.[5]
Summary
Based on the initial report by Bast et al.,[1] the serum level of 35 U/mL is considered as the cutoff point for CA125. The serum level of CA125 is widely used for distinguishing malignant from benign pelvic masses, for monitoring the response of epithelial ovarian cancer (EOC) to treatment, for follow-up, and for detecting disease recurrence. This marker has not proved a useful EOC screening test because of its low sensitivity and specificity.[2,3] serum levels of CA125 may be in the normal range in 50% of symptomatic stage I patients and in about 10%– 20% of advanced-stage patients.[3,4,5] Elevated CA125 levels are most common in patients with serous ovarian carcinoma (SOC), while the other types of EOC often present with normal serum CA125 levels.[5]. To stratify patients for optimal therapy, additional prognostic and predictive factors are needed
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