Premium
The prognostic value of perioperative, pre‐systemic therapy CA 125 levels in patients with high‐grade serous ovarian cancer
Author(s) -
May Taymaa,
Stewart Jocelyn M.,
Bernardini Marcus Q.,
Ferguson Sarah E.,
Laframboise Stephane,
Jiang Haiyan,
Rosen Barry
Publication year - 2018
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12376
Subject(s) - medicine , hazard ratio , confidence interval , proportional hazards model , univariate analysis , multivariate analysis , serous fluid , perioperative , oncology , surgery , gastroenterology
Objective To investigate the ability of preoperative CA 125 and post‐surgical CA 125 changes to predict outcomes among patients with high‐grade serous ovarian cancer ( HGSC ). Methods The present retrospective cohort study included patients with HGSC who underwent surgery between January 1, 2003, and December 31, 2011 at Princess Margaret Cancer Center, Toronto, ON , Canada. CA 125 was measured at diagnosis and following surgery, and the CA 125 ratio was calculated (preoperative CA 125/postoperative CA 125). Optimal CA 125 cutoff levels were identified using the point with the most significant log‐rank‐test result. Univariate and multivariate analyses with Cox proportional hazard modeling was used to study overall survival. Results Among 212 patients, an optimal baseline CA 125 cutoff value of 174 U/ mL and a seven‐fold decrease in CA 125 after surgery were positive prognostic indicators. A 10‐fold increase in baseline CA 125 was associated with decreased overall survival (univariate hazard ratio 1.55, 95% confidence interval [ CI ] 1.17–2.06; P =0.002; multivariate hazard ratio 1.72, 95% CI 1.21–2.44; P =0.002). An increase in the CA 125 ratio (log 10 [preoperative CA 125/postoperative CA 125]) was associated with improved overall survival (univariate hazard ratio 0.63, 95% CI 0.43–0.90; P =0.012; multivariate hazard ratio 0.41, 95% CI 0.24–0.70, P <0.001). Conclusion CA 125 demonstrated prognostic value for HGSC ; baseline CA 125 of 174 U/ mL or lower and a post‐surgical decline of seven‐fold or greater were associated with improved overall survival.