CA-125 Levels In Patients Research Articles

Clinical effects of IPCH after the surgery for ovarian cancer at the middle or advanced stage and its impacts on tumor markers and immune functions.

To evaluate the clinical effects of intraperitoneal chemohyperthermia (IPCH) in the treatment of postoperative patients with advanced stage ovarian cancer, and its impacts on tumor markers and immune functions. This is a retrospective study. One hundred and twenty patients with advanced stage ovarian cancer received in Shanghai 7th People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from May 10, 2022 to June 10, 2023 were selected and randomly divided into control and study groups (n=60 each group). Patients in the control group were administered routine intravenous chemotherapy, the study group underwent IPCH besides routine intravenous chemotherapy based on the control group. Comparatively analyzed the clinical effects, adverse reaction occurrence rates, and variations in relevant observation targets, the tumor marker after and before the treatment. Total efficacy in the study and control groups are proved to be with statistically significant differences. The occurrence of adverse reactions proved that no significant differences is seen between both groups. After the treatment, CEA, CA19-9, and CA125 levels in patients of the study group are apparently lower than those in the control group, showing statistically significant differences; expression levels of CD3+, CD4+ and CD4+/CD8+, in the study group were enormously above those in the control group after the treatment, with statistically significant differences. IPCH has the potential to effectively enhance comprehensively clinical therapeutic effects among postoperative patients with ovarian cancer, significantly improve patients' immune states, and evidently reduce expression levels of various tumor markers.

Association of preoperative CA-125 levels with early POAF after heart valve surgery: a single-center, retrospective study

ObjectiveCancer antigen-125 (CA-125), a tumor marker, has received increasing attention in recent years for its role in the cardiovascular field. However, no study has reported the association of CA-125 with early postoperative atrial fibrillation (POAF) after heart valve surgery. Therefore, the aim of this study was to assess whether there is a correlation between CA-125 and early postoperative POAF after heart valve surgery.MethodsPatients who underwent valve surgery at Fujian Heart Medical Center from January 2020 to August 2022 were retrospectively analyzed and divided into postoperative atrial fibrillation group (POAF group) and postoperative non-atrial fibrillation group (NO-POAF), and the differences in clinical data between the two groups were compared, and the variables with statistical significance in the univariate analysis were included in the COX regression analysis, and finally the receivers’ operating characteristics (ROC) curves were drawn.ResultsFrom January 2020 to August 2022, a total of 1653 patients underwent valve surgery. A total of 344 patients were finally included, including 52 patients (15.1%) in the POAF group and 292 patients (84.9%) in the NO-POAF group. Univariate analysis showed higher CA-125 levels in patients in the POAF group than in those in the NO-POAF group [27.89 (13.64, 61.54), 14.48 (9.87, 24.08), P = 0.000]. Analysis of the incidence of POAF based on CA-125 quartiles showed an incidence of up to 29.2% in the highest quartile (> 27.88). Multivariate COX regression analysis showed that CA-125 [OR = 1.006, 95% CI (1.002, 1.010), P = 0.001] was an independent predictor of POAF. The final ROC curve plot showed that the area under the curve for CA-125 was 0.669, with an optimal cut-off value of 27.08 U/ml, and the difference in the area under the curve between the two groups was statistically significant (P = 0.000).ConclusionElevated preoperative CA-125 levels can affect the incidence of POAF and have a predictive value for the occurrence of POAF in the early stage after valve surgery. However, due to the small sample size and single-center retrospective study, further validation of this result is needed.

Effects of GnRH Agonist and Dienogest in Combination on HE4 and CA125 Levels in Patients with Adenomyosis and Adenomyoma: A Prospective Cohort Study

Effects of GnRH Agonist and Dienogest in Combination on HE4 and CA125 Levels in Patients with Adenomyosis and Adenomyoma: A Prospective Cohort Study

Elevated levels of CA125 (MUC16) in metastatic gastric cancer as a strong predictor of poor survival

Introduction: CA125 is an extracellular domain of MUC16 glycoprotein. The clinical significance of serum CA125 has been most extensively studied in ovarian cancer. The significance of serum CA125 in gastric cancer has not been fully elucidated. There is evidence that MUC16 overexpression is associated with poor survival in patients with metastatic gastric cancer. We have not found any research papers on the correlation between the levels of serum CA125 and MUC16 overexpression.Objective: The objective of the study was to assess the effects of elevated CA125 levels in patients with metastatic cancer on the long‑term results (time to disease progression and overall survival).Materials and methods: CA125 was determined in the serum before the start of first‑line chemotherapy in 75 patients (45 males and 30 females) with metastatic gastric cancer. The mean age of the patients was 61,3 (26,7–84,9) years. Synchronous metastases were observed in 85 % of patients: 57,3 % in the peritoneum, 37,3 % in the liver, 5,4 % at other sites. Palliative gastrectomy and metastasectomy were performed in 28 % and 20 % of patients, respectively. Monotherapy, doublet and triplet chemotherapy regimens were used in 6,7 %, 58,7 % and 36,0 % of patients, respectively.Results: the analysis showed that elevated levels of CA125 (> 37 IU/mL) were associated with a significant reduction in median time to progression (3,5 months (CI 2,87–9,53) vs 6,2 months, р = 0.001 (CI 2,02–4,9)) and overall survival (5,1 months (CI 6,07–28,1) vs 17,1 months (CI 3,5–6,67), р = 0.001). One‑factor ANOVA showed that factors with the strongest effects on the survival rates included the location of metastases (peritoneum), tumor histology (adenocarcinoma/signet ring cell carcinoma), the use of palliative gastrectomy and metastasis resection. A multi‑factor ANOVA showed that the only favorable prognostic factors in terms of overall survival rates were normal CA125 levels (HR 0,39 (95 % CI 0,18–0,84), р = 0.001) and the use of palliative gastrectomy (HR 0,23 (95 % CI 0,1–0,58), р = 0.001). The use of triplet chemotherapy regimens allowed to slightly improve the overall survival rates in the group of patients with elevated CA125 levels; however, the differences were not statistically significant (6,7 months vs 4Ю0 months, p = 0.29).Conclusion: Elevated levels of CA125, which reflect MUC16 overexpression to a certain extent, is a strong independent predictor of poor outcome in metastatic gastric cancer. Currently, a possible way to overcome this negative impact is to use more intensive chemotherapy regimens. However, further research should be aimed at finding adequate targets and ways of neutralizing the negative impact of MUC16 overexpression in patients with metastatic gastric cancer.

Correlation of Preoperative Serum and Intraoperative Peritoneal Lavage Fluid Ca-125 Levels with Postoperative Tumor Histology in Patients with Endometrial Cancer: A Prospective-Controlled Study

Background The role of Ca-125 in endometrial cancer is not fully known. Some authors have reported high Ca-125 levels in patients with recurrent or advanced endometrial cancer, whereas others have stated that Ca-125 levels and the advance of the disease were not correlated in endometrial cancer. This makes it inevitable for clinicians to search for different measurement methods or interpretation of the present tumor markers. The aim of this study was to evaluate the relationship between Ca-125 values of the serum and abdominal lavage fluid and postoperative histopathological parameters in patients with endometrial carcinoma. Methods The study included patients who were diagnosed with endometrial cancer in the Gynecology Clinic and were planned to undergo surgery. The correlations of clinicopathological parameters with preoperative values of Ca-125 measured from serum and abdominal lavage fluid were investigated. The Spearman correlation test was applied in the analysis of correlations of serum and abdominal lavage fluid Ca-125 values with postoperative tumor characteristics. Results The serum Ca-125 values were determined to be positively correlated with surgical stage, tumor diameter, and lymph node involvement (p = 0.03; p = 0.04; and p = 0.01, respectively). No correlation was determined between tumor grade and serum Ca-125 level. The level of Ca-125 in the abdominal lavage fluid was observed to be correlated with surgical stage and tumor grade, but not with tumor diameter or lymph node involvement (p = 0.01, p = 0.04, respectively). Conclusions The value of Ca-125 in the abdominal lavage fluid has a positive correlation with the surgical stage and tumor grade in patients with endometrial carcinoma.

Preoperative Serum CA-125 Levels in Patients with Ovarian Cancer.

Introduction: A noteworthy proportion of patients with stage I disease have usual preoperative serum levels, and not all cell types rapid the antigen. Our aim of this study was to predict preoperative serum CA-125 levels in patients with ovarian cancer. Material & Methods: This cross-sectional study was carried out at the Department of Gynecological Oncology, Department of Gynae & Obstetric, Ashiyan Medical College Hospital, Barua Khilkhet, Dhaka, Bangladesh during the period from January 2015 to December 2015. A total of 100 patients were selected using purposive sampling technique for this study. Data were collected and documented on a preformed and pretested structured questionnaire. Clinical examination and relevant investigation were done and recorded accordingly. Data were processed and analyzed with the help of computer software SPSS 22. Results: Mean age of the study subjects was 45.7 ± 15.2 years with a range of 13-75 years. Table II shows education status of the study subjects. It was observed that half of the study subjects had education up to primary level, 26% had studied up to secondary level, 19% up to higher secondary level and only 5% were graduate. Mean BMI was 23.3± 3.0 kg/m2, mean age of marriage was 16.1± 2.8years and mean CA-125 level was 547.02± 478.74. Maximum study subjects had stage III (44.0%) followed by stage II (24.0%), stage I (21. 0%) and stage IV (11.0%). Also, most of the study subjects had serous tumors (70.0%) followed by mucinous tumors (11.0%), endometrioid adenocarcinoma (8.0%), clear cell tumors (4.0%), malignant tertoma (5.0%), Brenner (1.0%) and dysgerminoma (1.0%). Endometrioid adenocarcinoma was found in elderly study subjects and clear cell tumor was found in young aged study subjects. Histopathological type according to grading of ovarian tumor describes, all stage IV tumors were serous, all clear cell and Brenner tumors were stage I, and all endometrioid adenocarcinoma tumors were stage III. Serum CA-125 was elevated at the advanced stage of ovarian cancer. Conclusion: Serum CA-125 had significant positive correlation with surgical stage of ovarian cancer in epithelial cancer patients of this study. But in case of germ cell ovarian cancer, it showed a negative correlation

CA-125 and other prognostic factors associated with survival in stage I epithelial ovarian cancer: a study of 15,882 patients

<h3>Objectives:</h3> To investigate the prognostic value of demographic and clinicopathologic factors including CA-125 levels in patients with stage I epithelial ovarian carcinoma. <h3>Methods:</h3> Data was obtained from the National Cancer Database (NCDB PUF 2016). Patients were diagnosed with stage I epithelial ovarian cancer between 2004 and 2015. CA-125 results were reported as abnormal if they were ≥35 units/mL before treatment. Kaplan-Meier method, log-rank test, and multivariate Cox proportional hazards modeling were used for statistical analyses. <h3>Results:</h3> Of 15,882 patients with stage I epithelial ovarian carcinoma, the median age was 55 (range 18-90). The majority of patients were White (80.4%) and the remainder were Hispanic (6.4%), Black (6.1%), and Asian (5%). Stage IA, IB, IC, and stage I NOS were found in 54.2%, 3.8%, 36.3%, 5.7% of patients, respectively. There were 25.2% with endometrioid carcinoma, 20.9% with serous carcinoma, 20.7% with mucinous carcinoma, 15.6% with clear cell carcinoma and 17.6% with other epithelial subtypes. The 5-year overall survival (OS) was 86.0%. Black race was associated with worse OS at 82.6% compared to 85.6% of Whites (P=0.024). Those with higher substage IC vs IA and IB had worse survivals (82.7% vs 88.4% and 85.3%; P<0.001 and P=0.042). Those with clear cell or serous carcinoma had poorer outcomes compared to those with mucinous (83.0% or 84.4% vs 87.2%; P<0.001 or P=0.016) and endometrioid carcinoma (90.9%; P<0.001 or P<0.001). Tumors with LVSI had associated survival of 75.2% compared to 87.5% in those without LVSI (P<0.001). Patients with elevated pretreatment CA-125 levels had 84.4% OS compared to 89.4% for those with normal CA-125 values (P<0.001). Multivariate analysis demonstrated that Black vs. White race (HR=1.32, 95% CI, 1.10-1.59; P<0.003), Southern vs Northeast Region (HR=1.23, 95% CI, 1.07-1.40; P<0.003), mucinous vs serous histology (HR=1.67, 95% CI, 1.41-1.98; P<0.001), clear cell vs serous histology (HR=1.26, 95% CI, 1.08-1.46; P<0.003), stage IC vs IA (HR=1.50, 95% CI, 1.35-1.67; P<0.001), LVSI (HR=1.82, 95% CI, 1.35-2.45; P<0.001), grade 3 vs 1 (HR=2.21 95% CI, 1.87-2.61, P<0.001) and elevated vs normal CA-125 (HR=1.50, 95% CI, 1.31-1.71, P<0.001) were independent predictors for worse survival. <h3>Conclusions:</h3> Our data suggest that pretreatment CA-125 is an independent prognostic factor in women with stage I epithelial ovarian cancer. Other predictors of survival include race, region, sub-stage, cell type, grade, and LVSI.

Elevated serum interleukin-32 levels in patients with endometriosis: A cross-sectional study.

Recently, interleukin (IL)-32 has been suggested to be involved in the pathogenesis of endometriosis. The aim of this study was to investigate whether serum IL-32 level might be used as a biomarker for diagnosis of endometriosis. We recruited the serum samples of 50 patients with histologically confirmed endometriosis and 35 controls. Enzyme-linked immunosorbent assay was used to analyze the serum IL-32, IL-6, IL-10, tumour necrosis factor (TNF)-α, IL-1β, and CA-125 levels in patients with and without the disease and the diagnostic potentials of the cytokines were assessed using receiver operating characteristic curve and the area under the curve (AUC). Among evaluated cytokines, only serum IL-32 levels showed significant differences between patients with and without endometriosis (1111.24±149.59 vs 631.10±120.23ng/mL, P=0.018, respectively). When the diagnostic power of serum IL-32 was evaluated, the AUC was 0.638 (95% confidence interval (CI): 0.521-0.766, P=0.031). When serum IL-32 levels were combined with serum CA-125 levels, the AUC was increased to 0.749 (95% CI: 0.640-0.858, P<0.001) with sensitivity and specificity of 60.0% and 82.9% at cutoff value of 0.640, which led to detect 25 more cases of endometriosis than the use of serum CA 125 with the cutoff value of 35IU/mL (36/50 vs 11/50, P<0.001) without sacrificing the specificity of the marker. Serum IL-32 levels are elevated in patients with endometriosis, and with combination of serum CA-125 levels, it may serve as a potential biomarker for endometriosis.

Prognostic significance of elevated pre-treatment serum CA-125 levels in patients with stage I ovarian sex cord-stromal tumors

ObjectiveTo investigate the prognostic significance of elevated pre-operative serum CA-125 values for patients with early stage ovarian sex cord – stromal tumors (SCSTs). MethodsPatients diagnosed between 2004 and 2015 with a SCST were drawn from the U.S National Cancer Database. Those with stage I disease, and normal or elevated CA-125 values were selected for further analysis. Overall survival (OS) was evaluated for patients diagnosed between 2004 and 2014 with Kaplan-Meier curves, and compared with the log-rank test. A multivariate Cox analysis was performed to control for known confounders. ResultsA total of 1156 patients met the inclusion criteria; 486 (42%) had elevated pre-treatment CA-125 values. Patients with elevated pre-treatment CA-125 (n = 417) had worse OS compared to those with normal values (n = 588), p < 0.001 from log-rank test; 5-yr OS rates were 86.8% and 94.8% respectively. After controlling for patient age (<50 vs > = 50 yrs), the presence of medical co-morbidities, tumor histology (granulosa vs non-granulosa), size (<10 vs > = 10 cm vs unknown) and the performance of lymphadenectomy, elevated pre-treatment CA-125 levels were associated with a worse survival (HR: 1.80, 95% CI: 1.15, 2.82, p = 0.01). ConclusionsIn a large cohort of patients with early stage SCSTs elevated preoperative CA-125 levels were associated with worse survival.

The relationship of pelvic pain symptoms with CA-125 levels in endometriosis cases

Aim: This study aims to investigate the relationship between CA-125 levels and pelvic pain symptoms in patients with endometriosis.Material and Methods: This study consisted of retrospective data of 31 patients who were admitted to the outpatient clinic of Faculty of Medicine, Amasya University between 01 January 2013 and 01 January 2018 for complaints of pelvic pain, dysmenorrhea or infertility, who had a preliminary diagnosis of endometriosis by clinical and ultrasonography examination and diagnosed with endometriosis by laparoscopy or laparotomy as well as 35 patients who received diagnostic laparoscopy for any reason or laparotomy or laparoscopy for benign or tubal ligation. The study included patients aged 18 to 45 years old. Patient data were recorded via an information form which included age, presence of infertility, duration of infertility, preoperative CA-125 values, presence of dysmenorrhea and dyspareunia symptoms, previous operation for endometriosis, presence of additional gynecological pathology, disease stage, operation notes, primary complaints, preoperative TVS information, gravida, parity, abortion and living children, used medication, if any, chronical diseases, if any. Results: The blood CA-125 levels were statistically significant in the patients considering the presence of chronic pelvic pain, dysmenorrhea and infertility (p 0.05). Mean CA-125 levels were 51.43 U/ml in patients with chronic pelvic pain symptoms. Mean CA-125 levels were 45.45 (U/ml) in patients with dysmenorrhea. Mean CA-125 was 45.67 (U/ml) in infertile patients and 45.58 (U/ml) in patients with endometriosis. Mean CA-125 levels in patients with additional gynecological diseases were 38.29 (U/ml), which was not statistically significant.Conclusion: This study demonstrated that CA-125 levels were significantly associated with pelvic pain symptoms, infertility and endometriosis. In light of the results, preoperative serum CA-125 levels are a predictor and should be considered for patients with chronic pelvic pain.Keywords: Endometriosis; CA-125; pelvic pain.

Correlation between ovarian chocolate cyst and serum carbohydrate antigen 125 level and the effect of ultrasound-guided interventional sclerotherapy on serum carbohydrate antigen 125 level.

This study was to investigate the correlation between ovarian chocolate cysts and serum carbohydrate antigen (CA)-125 levels and to demonstrate the effect of ultrasound-guided interventional sclerotherapy (UGIS) on serum CA-125 levels. Based on the serum CA-125 level, as determined by chemiluminescence detection prior to UGIS, 105 patients with ovarian chocolate cysts were divided into the normal group (CA-125 ≤ 35 U/mL, 45 patients) and the abnormal group (35 U/mL < CA-125 ≤ 200 U/mL, 60 patients). There were six clinical indicators including age, disease duration, dysmenorrhea history, child-bearing history, abortion history and surgical history. The ultrasonography characteristics were cyst diameter, cyst wall thickness and the side on which the cyst occurred. The correlations between serum CA-125 levels pretreatment and the clinical indicators and ultrasonography characteristics was analyzed. The serum CA-125 levels pretreatment, 3 months post-treatment and 6 months post-treatment were compared. The pretreatment serum CA-125 levels of the 105 patients positively correlated with disease duration (r = 0.3932, P = 0.0040), dysmenorrhea history (r = 0.2351, P = 0.0111), cyst diameter (r = 0.3415, P < 0.0001) and cyst wall thickness (r = 0.4263, P < 0.0001). Compared with the pretreatment level, the mean serum CA-125 level in the abnormal group at 3 months post-treatment was significantly lower (P < 0.01), and at 6 months post-treatment, the mean serum CA-125 level had decreased to a normal level (P < 0.01). UGIS significantly decreased abnormal serum CA-125 levels in patients with ovarian chocolate cysts.

The prognostic significance of pre- and post-treatment CA-125 in grade 1 serous ovarian carcinoma: A Gynecologic Oncology Group study

ObjectivesThe study objective was to determine the prognostic significance of serum CA-125 levels in patients with grade 1 serous ovarian carcinoma (SOC) enrolled in a Phase III study. MethodsAn ancillary analysis of a phase III study of women with advanced epithelial ovarian cancer treated with carboplatin/paclitaxel versus triplet or sequential doublet regimens. Grade 1 SOC was used as a surrogate for low-grade serous carcinoma. ResultsAmong 3686 enrolled patients, 184 (5%) had grade 1 disease and CA-125 levels available. For those with grade 1 SOC, the median patient age was 56.5; 87.3% had Stage III disease. Median follow-up was 102months and there was no difference in pre-chemotherapy CA-125 by treatment arm (P=0.91). Median pretreatment CA-125 for those with grade 1 SOC was lower (119.1) than for patients with grade 2–3 SOC (246.7; P<0.001). In those with grade 1, pretreatment CA-125 was not prognostic of outcome. However, patients with CA-125 levels that normalized after cycle 1, 2 or 3 were 60–64% less likely to experience disease progression as compared to those who never normalized or normalized after 4cycles (P≤0.024). Normalization of CA-125 levels before the second cycle was negatively associated with death, with a HR of 0.45 (P=0.025). ConclusionsPretreatment CA-125 level was significantly lower in women with grade 1 SOC compared to those with high-grade SOC. While pretreatment CA-125 was not associated with survival, serial CA-125 measurements during chemotherapy treatment were prognostic, with normalization before the second chemotherapy cycle associated with a decreased risk of death.

Predictive value of preoperative serum CA-125 levels in patients with uterine cancer: The Asian experience 2000 to 2012

ObjectiveMuch of the early investigative work on the usefulness of preoperative serum CA-125 levels in identifying patients with early-stage endometrial carcinoma who have occult metastases were carried out in Europe and the United States. This article reviews CA-125 as a possible index for determining the need for full surgical staging, from the results of large medical centers in Asia, particularly Taiwan and Korea.MethodsA Medline search was performed using CA-125 and endometrial cancer as index words from 1981 to 2012. Those publications felt to be the most important especially from institutions from Asia since 2000 were identified in this review.ResultsMost articles that analyzed the utility of serum CA-125 levels as predictive marker for disease extent or prognosis in uterine cancer used univariate and multivariable logistic regression analysis, and performed receiver operative curves to find the best cut-off values. The main factor of interest was whether clinicians can stratify patients that need lymphadenectomy in early stage disease. Suggested optimal cut-off value ranged from 20 to 210 U/mL. Not only preoperative CA-125 level, but myometrial invasion status by magnetic resonance imaging was the most significant combined parameter for predicting disease extent.ConclusionElevated CA-125 in patients with apparent early-stage disease is clearly a risk factor for the presence of extra-uterine disease although the optimal cut-off levels vary. The evolution of clinical investigations over the past decade, particularly in Asia, suggests employment of the test in a more focused manner to identify high risk patients preoperatively.

CURRENT APPROACHES TO EVALUATING THE EFFICIENCY OF TREATMENT FOR REPRODUCTIVE TRACT TUMORS BY RECIST OR GCIG CRITERIA

The present communication discusses unified criteria for assessing the response evaluation criteria in solid tumors (RESIST) that are used to determine complete and partial responses, stabilization, and progression. It gives a classification of gynecological cancer intergroup (GCIG) criteria for elevated CA125 levels in patients with ovarian cancer after termination of primary therapy, which can determine the time of disease progression in patients having isolated growth of the marker during monitoring, without revealing tumor foci.

The prognostic significance of pre and post-treatment CA-125 levels in low grade serous ovarian carcinoma: A Gynecologic Oncology Group study

Objective: The study objective was to determine the prognostic significance of pre and post-treatment serum CA-125 levels in patients (pts) with advanced low grade serous ovarian carcinoma (LGSC) enrolled in a Phase III study.

The clinical significance of the determination of serum CA19-9 and CA125 levels in patients with Budd-Chiari syndrome

The clinical significance of the determination of serum CA19-9 and CA125 levels in patients with Budd-Chiari syndrome

Predictive value of serum CA-125 levels in patients with persistent or recurrent epithelial ovarian cancer or peritoneal cancer treated with bevacizumab on a Gynecologic Oncology Group phase II trial

ObjectiveTo compare two methods of determining therapeutic response and disease progression — modified Gynecologic Cancer Intergroup (GCIG) criteria based on CA-125 and Radiographic Evaluation Criteria in Solid Tumors (RECIST), in a phase II trial of bevacizumab for patients with recurrent or persistent epithelial ovarian and peritoneal carcinoma. MethodsPatients were treated with bevacizumab 15mg/kg every 21days. Modified GCIG definitions of progression and response were retrospectively applied and compared to RECIST-defined progression and response. The prognostic significance of CA-125- and RECIST-defined responses and progressions were explored. ResultsSixty-two patients were evaluable by RECIST, 59 for progression by CA-125, and 45 for response by CA-125. Median progression-free survival (PFS) by RECIST and progression-free interval (PFI) by CA-125 were 4.7 and 5.2months respectively. However, 12.9% of those with CA-125 defined progression remained progression-free according to RECIST for at least 8months. Thirteen of 62 patients (21%) had response by RECIST and 14/45 (31%) by CA-125. Time dependent analyses indicated that progression by CA-125 was associated with a 5.2 fold increased risk of progression by RECIST, and response by CA-125 had a 5 fold decrease in risk of progression by RECIST. Landmark and time dependent analyses showed prognostic value of responses by CA-125 and RECIST. ConclusionsIn this study, disease assessment by RECIST and CA-125 appears to correlate in general. However, approximately 10% of patients might demonstrate progression earlier by CA-125.

Prognostic impact of perioperative CA-125 levels in patients with endometrial cancer.

e15573 Background: Endometrial cancer is one of the most common gynecologic cancers in the western world, and serum CA-125 levels have been widely used clinically for preoperative diagnosis and pre...

Prognostic impact of prechemotherapy HE4 and CA-125 levels in patients with ovarian cancer

Prognostic impact of prechemotherapy HE4 and CA-125 levels in patients with ovarian cancer

Prediction of a high-risk group based on postoperative nadir CA-125 levels in patients with advanced epithelial ovarian cancer

ObjectiveWe aimed to determine the ideal cut-off of nadir serum CA-125 level for prediction of progression free survival.MethodsAmong 267 patients who achieved complete remission after chemotherapy, the correlation between nadir CA-125 and progression free survival were compared among the subgroups classified according to the distribution of CA-125. The diagnostic odds ratio and area under the receiver operator characteristics curve were compared at various cut-off points.ResultsThe nadir CA-125 levels did not have prognostic value under 12 U/mL (to 75 percentile). In contrast, they were significantly correlated with progression free survival only when the CA-125 level was greater than 12, which was 75 percentile (p=0.034). In predicting progression free survival <6 and 12 months, the cut-off value of 18 (90 percentile) showed superior diagnostic performance over 10 or 12 U/mL. Compared with patients who showed nadir levels between 0 and 12 U/mL (0 to 75 percentile), those with nadir >18 U/mL showed a hazard ratio of 2.85 (95% confidence interval, 1.70 to 4.76; p<0.001); patients with nadir levels between 18 and 12 U/mL showed a the hazard ratio of 1.68 (95% confidence interval, 1.11 to 2.56; p=0.015) compared with those whose nadir levels were under 12 U/mL.ConclusionThe predictive power of the traditional cut-off of 10 U/mL to classify a risk group or to identify high risk patients was unsatisfactory. The optimal diagnostic performance was observed at the cut-off of 18 U/mL and this can be proposed to dichotomize cut-off values to predict outcomes among individual patients.