Prognostic value of serum CA125 level change during chemotherapy post-surgery in patients with advanced epithelial ovarian carcinoma / 中华妇产科杂志

ABSTRACT

Objective To investigate the prognostic value of the changes in serum CA125 level during chemotherapy post-surgery in patients with advaneed epithelial ovarian carcinoma.Methods A retrospective analysis was conducted on 142 patients with stage Ⅲ-Ⅳ epithelial ovarian carcinoma who had primary treatment in the Cancer Center of the Sun Yat-sen University during January 1998 to December 2003.The changes in CA125 levels during chemotherapy post-surgery in patients were analyzed.The survival outcomes of patients with various levels of CA125 were studied using Kaplan-Meier method.Multivariate Cox regression model Wag used to aggess the correlations between survival and the change in CA125 level during chemotherapy and other prognostic factors.Results The 3-year overall survival(OS)was 64%,71%,and 64%respectively in patients with different pretreatment CA125 levels(≤500,>500-1500 and>1500 kU/L;P>0.05).The CA125 level was normalized(0-35 kU/L)in 77(54.2%)patients after three cycles of postoperative chemotherapy.It revealed significant differences in 3-year OS(84%vs.42%)and 5-year OS(56%vs.15%)between the patients with normalized and elevated CA125 levels(n=48)after three cycles of chemothempy(P<0.01).Multivariate analysis showed that residual tumor size>1 cm(P<0.01)and elevated CA125 after three-cycle postoperative chemotherapies(P<0.01)were two independent factors related to survival.In the subgroup of optimal cytoreduction(residual tumor size≤1 cm),the 3-year and 5-year OS rate were 88%and 64%for patients with normalized CA125 level after three cycles of chemotherapy respectively,while only 52%and 18%for patients with elevated CA125 level(P<0.01).Similarly,even in the suboptimal cytoreduction group,the 3-year and 5-year OS were also significantly increased for patients with normalized CA125 level after three cycles of chemotherapy post-surgery,as compared with patients with elevated CA125 level(74%vs.33%in 3-year OS,32%vs.13%in 5-year OS;P<0.01).Conclusions CA125 level after three cycles of chemotherapy post-surgery is an independent predictor of survival for advanced ovarian carcinoma.Whatever the patients undergo,optimal or suboptimal cytoreduction,ifthe CA125 becomes normalized after three cycles of chemotherapy,they would have more favorable prognosis than those with elevated CA125 after three cycles of chemotherapy.