Serum CA125 regression in epithelial ovarian cancer: Correlation with reassessment findings and survival

AbstractObjectiveTo evaluate the diagnostic value of combination detection of serum cancer antigen 125 (CA125), carbohydrate antigen 19-9 (CA199) and carci noembryonic antigen(CEA) in patients with epithelial ovarian cancer by pooling the open published studies according to meta-analysis method.MethodsDiagnostic studies related to combination detection of serum CA125, CA199 and CEA in patients with epithelial ovarian cancer were electronic searched in the databases of PubMed, Cochrane, Google scholar, EMBASE, ISI Web of Knowledge and CNKI by two independent reviewers. The combined diagnostic sensitivity, specificity, positive likely hood ratio (+LR), negative likely hood ratio (-LR), diagnostic odds ratio (DOR), and area under the receiver operating characteristic curve (AUC) were pooled by Med DiSc1.4 software.ResultsTwelve prospective diagnostic publications were finally fulfilled the inclusion criteria and were included in this meta-analysis. The pooled diagnostic sensitivity specificity, positive likely hood ratio, negative likely hood ratio, diagnostic odds ratio, and AUC were 0.90 (95%CI: 0.80 to 0.92), 0.83 (95%CI: 0.80 to 0.86), 5.35(95%CI:3.90 to 7.33), 0.13 (95%CI: 0.10 to 0.16), 48.53 (95%CI: 29.91 to 78.72) and 0.92 (95%C: 0.89 to 0.94) respectively by fixed or random effect model. No publication bias was found according to the funnel plot and line regression test (t=-1.34, P=0.21).ConclusionCombination detection serum CA125, CA199 and CEA was a promising biomarker forepithelial ovarian cancer diagnosis with relative high sensitivity and specificity.

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Getting the MOST out of follow-up: a randomized controlled trial comparing 3 monthly nurse led follow-up via telehealth, including monitoring CA125 and patient reported outcomes using the MOST (Measure of Ovarian Symptoms and Treatment concerns) with routine clinic based or telehealth follow-up, after completion of first line chemotherapy in patients with epithelial ovarian cancer

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2021-002999 ◽

2021 ◽

pp. ijgc-2021-002999

Author(s):

Paul A Cohen ◽

Penelope M Webb ◽

Madeleine King ◽

Andreas Obermair ◽

Val Gebski ◽

...

Keyword(s):

Ovarian Cancer ◽

Cost Effectiveness ◽

Epithelial Ovarian Cancer ◽

Recurrent Disease ◽

Emotional Wellbeing ◽

First Line ◽

Patient Reported ◽

Serum Ca125 ◽

Line Chemotherapy

BackgroundPhysical symptoms, anxiety, depression, fear of recurrence, sexual dysfunction, and social withdrawal are common in women after treatment for ovarian cancer. Most patients would like and need help dealing with these symptoms. The traditional model of follow-up care is unstructured and largely focused on diagnosing recurrent disease, and most oncologists lack skills to identify and manage psychosocial issues. No high quality prospective clinical trials have been conducted to determine the optimal follow-up regimen or the cost effectiveness of ovarian cancer surveillance strategies.Primary Objective(s)To assess emotional wellbeing, acceptability, safety, and cost effectiveness of nurse led follow-up via telehealth for women with ovarian cancer following completion of primary treatment.Study HypothesisWe hypothesize that compared with routine clinic based follow-up, nurse led follow-up via telehealth, including serum CA125 monitoring and completion of a patient reported outcome instrument, the Measure of Ovarian Symptoms and Treatment concerns-Surveillance (MOST-S26), will improve emotional wellbeing in women with ovarian cancer; be feasible, safe, acceptable, and not delay the time to diagnosis of recurrent disease; will result in greater patient satisfaction; will identify more patients with psychological distress, lead to better care, and improved psychological outcomes; and be cost-effective.Trial DesignPhase II multicenter randomized trial comparing 3 monthly nurse led telehealth consultations that include serum CA125 monitoring and completion of the MOST-S26, with routine clinic based follow-up. The allocation ratio will be 1:1.Major Inclusion/Exclusion CriteriaEligible patients will be women with high grade epithelial ovarian cancer who have normalized serum CA125 (to <35 kU/L) at completion of first line chemotherapy.Primary Endpoint(s)Emotional wellbeing at 12 months.Sample Size150 patients.Estimated Dates for Completing Accrual and Presenting ResultsJuly 2023. Results expected in 2025, 24 months after the last participant is enrolled.Trial RegistrationACTRN12620000332921

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The Combination of Serum Biomarker (CA-125, FASN, and GLS) as a Predictor Suboptimal Cytoreduction in Epithelial Ovarian Cancer

10.21203/rs.2.21972/v1 ◽

2020 ◽

Author(s):

Gatot Nyarumenteng Adhipurnawan Winarno ◽

Yudi Mulyana Hidayat ◽

Setiawan Soetopo ◽

Sofie Rifayani Krisnadi ◽

Maringan Diapari Lumban Tobing ◽

...

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Cytoreductive Surgery ◽

Cross Sectional Study ◽

Ca 125 ◽

Cross Sectional ◽

Average Value ◽

Preoperative Serum ◽

Serum Ca125 ◽

Sensitivity Specificity

Abstract Purpose. Cytoreduction has an important role in improving the survival rate of epithelial ovarian cancer (EOC) patients. The use of preoperative CA-125 as an optimal predictor cytoreduction in patients with ovarian cancer is still controversial. This study aimed to assess the ability of preoperative serum CA125, FASN and GLS as a predictor of cytoreductive surgery in epithelial ovarian cancer (EOC). This observational-analytic cross-sectional study included 109 women diagnosed with epithelial ovarian cancer (EOC) between 2017-2019, who had serum CA-125, GLS, FASN measured preoperatively and underwent cytoreductive surgery. Result. The average value of serum CA-125, FASN, and GLS in the suboptimal cytoreduction were higher than the optimal cytoreduction group. The cut off point (COP) of CA-125 was 248.55 (p=0.0001) with 73.2% sensitivity and 73.6% specificity, FASN was 0.445 (p=0.017) with 62.5% sensitivity and 60.4% specificity, and GLS was 22.895 (p=0.0001) with 73.2% sensitivity and 75.5% specificity. The COP value of CA-125 and GLS combined was 29.16 (p=0.0001) with sensitivity 82.1% and spesificity 73.6%, while the COP of CA-125, GLS, and FASN combined was 0.83 (p=0.0001) with 87.5% sensitivity and 73.6% specificity. If the value of biomarker serum more than COP will more likely have suboptimal cytoreductive surgery. Conclusion. The role of CA125, FASN and GLS levels in predicting suboptimal cytoreductive surgery for patients with ovarian cancer seems questionable. However, the combination of CA-125 and GLS or CA-125, FASN and GLS are able to increase the sensitivity, specificity, and accuracy classification to predict suboptimal cytoreductive surgery.

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Abstract B15: A cancer-specific detection of serum CA125 improves differential diagnosis of epithelial ovarian cancer from benign conditions

10.1158/1557-3265.ovca17-b15 ◽

2018 ◽

Author(s):

Kaisa Huhtinen ◽

Kamlesh Gidwani ◽

Henna Kekki ◽

Johanna Hynninen ◽

Liina Salminen ◽

...

Keyword(s):

Ovarian Cancer ◽

Differential Diagnosis ◽

Epithelial Ovarian Cancer ◽

Specific Detection ◽

Serum Ca125

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The Potential Value of CA125 as a Tumour Marker in Small Volume, Non-Evaluable Epithelial Ovarian Cancer

The International Journal of Biological Markers ◽

10.1177/172460089100600406 ◽

1991 ◽

Vol 6 (4) ◽

pp. 247-252 ◽

Cited By ~ 10

Author(s):

D.J. Cruickshank ◽

P.B. Terry ◽

W.T. Fullerton

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Small Volume ◽

Surgical Excision ◽

Complete Response ◽

Tumour Volume ◽

Tumour Marker ◽

Complete Surgical Excision ◽

Serum Ca125 ◽

Serial Serum

Seventy four consecutive patients with epithelial ovarian cancer have been followed up longitudinally with serial serum CA125 for up to 48 months. From this database, the CAl25 changes in small volume disease have been evaluated. For long term complete responders (n = l2), the mean plateau level of CA125 was 7.2 U/ml (95% confidence interval; 5.6 to 9.2 U/ml). The natural half-life of CA125 at 5.1 days (range 3.8 to 7 days) was calculated from five patients with Stage I and II disease who underwent complete surgical excision. A mean lead time of 99 days (range 14 to 255 days) was demonstrated between marker detection of disease progression and clinically apparent progressive disease in 12 out of 13 patients (92%) who relapsed after chemotherapy induced complete remission. The threshold of tumour volume detection with CA125 is unlikely to be determined by an arbitrary cut-off level. The kinetics of CA125 provide more useful information and the potential to define complete response or indeed cure with CA125 parameters requires further investigation.

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