Open AccessDoes preoperative CA-125 cutoff value and percent reduction in CA-125 levels correlate with surgical and survival outcome after neoadjuvant chemotherapy in patients with advanced-stage ovarian cancer? – Our experience from a tertiary cancer institute
Author(s) -
Monisha Gupta,
Shilpa M. Patel,
Ruchi Arora,
Rajneesh Tiwari,
Pariseema Dave,
Ajesh Desai,
Meeta Mankad
Publication year - 2020
Publication title -
south asian journal of cancer
Language(s) - English
Resource type - Journals
eISSN - 2278-4306
pISSN - 2278-330X
DOI - 10.4103/sajc.sajc_53_17
Subject(s) - medicine , stage (stratigraphy) , chemotherapy , retrospective cohort study , ovarian cancer , overall survival , gastroenterology , cancer , oncology , surgery , gynecology , paleontology , biology
Aim: The aim of the study is to evaluate percent fall in CA-125 levels after neoadjuvant chemotherapy (NAC) and preoperative CA-125 value to predict surgical and survival outcomes in women with advanced-stage epithelial ovarian cancer (EOC). Methods: A retrospective review of 406 women receiving NAC for advanced-stage EOC from January 2012 to July 2015 was conducted. Data were collected for demography, radiographic profile, CA-125 levels before and after NAC, chemotherapy, and surgicopathological information. Percent fall in CA-125 was categorized into two groups: 95% (R > 95) fall from prechemotherapy to preoperative levels. Similarly, women were also categorized using preoperative CA-125 levels of 100 U/ml. A subset of women from January 2012 to December 2013 was followed to June 2015 for evidence of any recurrence to determine survival outcomes. Results: About 56% women had R > 95 and 44% had R 95 group was more likely to have complete cytoreduction (P = 0.00). Furthermore, women with R > 95 had significant better progression-free survival (PFS) as compared to women with R 95% fall in CA-125 and an absolute preoperative CA-125 value of <100 U/ml is associated with better surgical and survival outcome in women with advanced EOC. These data are important in patient counseling and treatment planning.