Clinical Significance of CA125 Level after the First Cycle of Chemotherapy on Survival of Patients with Advanced Ovarian Cancer

PURPOSE: To determine the most powerful cancer antigen 125 (CA125)-related prognostic factor for advanced epithelial ovarian cancer (EOC) and to identify cut-off values that distinguish patients with a poor prognosis from those with a good prognosis. MATERIALS AND METHODS: We included 223 patients who received staging laparotomy and were diagnosed with stage IIC-IV serous EOC. Cox regression analysis was used to determine the most significant prognostic factor among the following variables: serum CA125 before surgery and after the first, second, and sixth cycles of chemotherapy; the nadir CA125 value; the relative percentage change in CA125 levels after the first and second cycles of chemotherapy compared to baseline CA125; CA125 half-life; time to nadir; and time to normalization of the CA125 level. RESULTS: The CA125 level after the first chemotherapy cycle was the most significant independent prognostic factor for overall survival (OS). Time to normalization (p=0.028) and relative percentage change between CA125 levels at baseline and after the first chemotherapy cycle (p=0.021) were additional independent prognostic factors in terms of OS. The CA125 level after the first chemotherapy cycle (p=0.001) and time to normalization (p<0.001) were identified as independent prognostic factors for progression free survival (PFS). CONCLUSION: Among well-established CA125-related prognostic factors, serum CA125 levels after the first cycle of chemotherapy and time to normalization were the most significant prognostic factors for both OS and PFS.

Removal of non-palpable Implanon(TM) by ultrasound guidance / 대한산부인과학회지

OBJECTIVE: This study was designed to analyze outcome of removal of non-palpable Implanon(TM) by ultrasound guidance. METHODS: This is retrospective study of patients who were referred from local clinic where removal of non-palpable Implanon(TM) had been failed. The cases were 32 patients who visited to Yonsei University Gangnam Severance Hospital between March 2004 through March 2009. RESULTS: Implanons(TM) were localized on ultrasound in all 32 cases. 18 cases were located in subcutaneous layer, 10 cased were located in fascial layer, 4 cases were located in muscle layer. All cases were successfully removed. The average length of time required for removal was 19.3 minutes. There was no complication except one patient, who had mild median nerve injury. CONCLUSION: Ultrasound guidance removal was safe and effective procedure to remove non palpable Implanon(TM).