CA-125 LEVEL AFTER ADJUVANT CHEMOTHERAPY AND RISK OF RELAPSE

Gynecol Oncol. 2009 Oct 8. [Epub ahead of print]

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Value of serum CA125 levels in patients with high-risk, early stage epithelial ovarian cancer.

Kang WD, Choi HS, Kim SM.

Department of Obstetrics and Gynecology, Chonnam National University Medical School, 8 Hakdong, Dong-gu, Gwangju, Republic of Korea.

OBJECTIVES: The aim of this study was to ascertain whether serum CA125 level is predictive of disease progression in patients with high-risk, early stage (stage IA/B grade 3, stage IC any grade, stage I clear cell, or stage II) epithelial ovarian cancer who have achieved a complete response to chemotherapy. METHODS: Between January 1998 and April 2004, we reviewed the records of 95 patients with high-risk, early stage epithelial ovarian cancer who had elevated CA125 levels at the time of diagnosis and were complete responders after 6 cycles of adjuvant paclitaxel/carboplatin chemotherapy. A receiver operating characteristic curve was used to determine the most useful CA125 level in predicting disease progression and Cox proportional hazards models adjusted for covariates were used for analyses. RESULTS: The 5-year progression-free survival (PFS) was 70.5%. The optimal cutoff point of CA125 after completing adjuvant chemotherapy to predict disease progression was 12 U/mL (sensitivity, 71.4%; specificity, 82.1%). On multivariate analysis, CA125 level>12 U/mL after completing adjuvant chemotherapy was an independent prognostic factor predictive for disease progression. The risk of recurrence was higher for CA125 level>12 U/mL (hazards ratio=10.567; P<0.001).>12 U/mL (P<0.001). CONCLUSIONS: CA125 level after 6 cycles of adjuvant chemotherapy is a strong independent prognostic factor for high-risk, early stage epithelial ovarian cancer after achieving a complete response.