Changes in serum CA-125 can predict optimal cytoreduction to no gross residual disease in patients with advanced stage ovarian cancer treated with neoadjuvant chemotherapy

2012 ◽  
Vol 125 (2) ◽  
pp. 362-366 ◽  
Author(s):  
Noah Rodriguez ◽  
J. Alejandro Rauh-Hain ◽  
Melina Shoni ◽  
Ross S. Berkowitz ◽  
Michael G. Muto ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Residual Disease ◽  
Ca 125 ◽  
Advanced Stage ◽  
Optimal Cytoreduction

Predictors for optimal cytoreduction following neoadjuvant chemotherapy in advanced epithelial ovarian carcinoma

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5512-5512
Author(s):  
D. de Jong ◽  
J. E. Dodge ◽  
O. Freedman ◽  
E. Lo ◽  
B. P. Rosen ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Independent Predictor ◽  
Residual Tumor ◽  
Multivariate Regression Analysis ◽  
Ca 125 ◽  
Advanced Stage ◽  
Optimal Cytoreduction ◽  
Primary Tumors ◽  
Predictive Parameters

5512 Background: Neoadjuvant chemotherapy (NAC) is increasingly used to treat patients (pts) with presumed advanced-stage epithelial ovarian cancer (EOC) who are deemed ineligible for upfront debulking surgery (DS). DS following NAC offers a survival benefit to those pts in whom optimal cytoreduction (< 1 cm residual tumor) is achieved. However, not all women who commence NAC have a subsequent attempt at DS. The aims of this study were to identify, in pts planned for NAC, predictive parameters for attempting DS and for achieving optimal cytoreduction in those undergoing surgery. Methods: Pts with presumed stage IIIC or IV EOC who started NAC between 1998 and 2004 were selected for chart review from our institutional ovarian cancer database. Pts with synchronous primary tumors or final pathology inconsistent with EOC were excluded. Age, presence of ascites, Pre NAC hemoglobin (Hb), platelet count (Pls), and CA-125 were explored as possible predictors of attempting DS and of optimal cytoreduction using Kruskal-Wallis analysis and multivariate regression analysis with backward elimination. Results: 212 pts met inclusion criteria. 164 pts (77.4%) had an attempt at DS after NAC; of these 109 pts (66.4%) were optimally cytoreduced. Age and pre-NAC Pls were independent predictors for attempting DS. Median age of pts undergoing DS was 65 years (range 42–82 yrs) compared to 77 yrs (range 54–89 yrs) in those in whom there was no DS attempt, p < 0.01. Median pre NAC Pls of pts undergoing DS was 398 (range 220–685) *109/L, compared to 298 (178–519) for those not proceeding to DS, p < 0.001. Pre NAC Hb, CA125, and ascites were not predictors of DS. Among pts undergoing DS, age was the only independent predictor of optimal cytoreduction identified: median age of pts (optimal vs. suboptimal cytoreduction) was 57yrs (range 42–73 yrs) vs. 67 yrs (49–82yrs), p < 0.001. Presence of ascites, pre-NAC Hb, pre-NAC Pls, and pre-NAC CA-125 were not predictors of optimal cytoreduction. Conclusions: At our centre, pt age and pre-NAC Pls are independent predictors for attempting DS following NAC for advanced stage EOC. In pts undergoing DS age was the only independent predictor of optimal cytoreduction identified. Further investigation of these findings is warranted. No significant financial relationships to disclose.

scholarly journals Evaluation of various kinetic parameters of CA-125 in patients with advanced-stage ovarian cancer undergoing neoadjuvant chemotherapy

PLoS ONE ◽  
2018 ◽  
Vol 13 (9) ◽  
pp. e0203366
Author(s):  
Yong Jae Lee ◽  
In Ha Lee ◽  
Yun-Ji Kim ◽  
Young Shin Chung ◽  
Jung-Yun Lee ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Kinetic Parameters ◽  
Ca 125 ◽  
Advanced Stage

scholarly journals Rethinking Radical Surgery in Interval Debulking Surgery for Advanced-Stage Ovarian Cancer Patients Undergoing Neoadjuvant Chemotherapy

2020 ◽  
Vol 9 (4) ◽  
pp. 1235 ◽  
Author(s):  
Yong Jae Lee ◽  
Jung-Yun Lee ◽  
Eun Ji Nam ◽  
Sang Wun Kim ◽  
Sunghoon Kim ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Disease Burden ◽  
Residual Disease ◽  
Advanced Stage ◽  
Debulking Surgery ◽  
Cox Regression Analysis ◽  
Interval Debulking Surgery ◽  
Surgical Complexity

The aim of this study is to evaluate the effects on survival outcomes of the disease burden before interval debulking surgery (IDS), surgical complexity, and residual disease after IDS in advanced-stage ovarian cancer treated with neoadjuvant chemotherapy (NAC). We reviewed the data of 268 epithelial ovarian cancer patients who had received three or four cycles of NAC and undergone optimal resections through IDS. The Kaplan–Meier method and Cox regression analysis were used to assess the effects of disease burden (peritoneal cancer index (PCI)), degree of complexity of surgery (surgical complexity score/s (SCS)), and extent of residual disease. In no residual disease (R0) patients, those with intermediate/high SCS had shorter progression-free survival (PFS; p = 0.001) and overall survival (OS; p = 0.001) than patients with low SCS. An analysis of a subset of patients with R0 and low PCIs showed those with intermediate/high SCS had worse PFS and OS than patients with low SCS (p = 0.049) and OS (p = 0.037). In multivariate analysis, patients with R0 as a result of intermediate/high SCS fared worse than patients whose R0 was achieved by low SCS (PFS hazard ratio (HR) 1.80, 95% CI 1.05–3.10; OS HR 5.59, 95% CI 1.70–18.39). High PCIs at the time of IDS, high SCS, and residual disease signal poor prognoses for patients treated with NAC.

scholarly journals The clinical and pathological characteristics and survival of patients with advanced ovarian cancer

2021 ◽  
Vol 52 (3) ◽  
pp. 205-210
Author(s):  
Miroslav Popović ◽  
Tanja Milić-Radić ◽  
Arnela Cerić-Banićević
Keyword(s):  
Ovarian Cancer ◽  
Residual Disease ◽  
Advanced Ovarian Cancer ◽  
Figo Stage ◽  
Ovarian Tumour ◽  
Ca 125 ◽  
Optimal Cytoreduction ◽  
Chi Square ◽  
Pathological Characteristics ◽  
Significant Difference

Introduction: Ovarian cancer has the highest mortality rate of all gynaecologic malignancies. The aim of this study was the evaluation of the clinical pathological characteristics and survival analysis of primarily operated patients with advanced stages of malignant epithelial ovarian tumour. Methods: The research was conducted as a cohort study with 59 patients with FIGO stage III and IV, which were primarily operated between 1 January 2008 and 31 December 2010 (three years). Age, comorbidities, BMI, presence of ascites, the level of the marker CA-125, histopathology and FIGO stage were analysed. The survival rate was estimated at the level of 1, 3 and 5 years. Results: The median age was 53 years (range 29-86). The most common histopathological type was serous (66.1 %) and the most common FIGO stage was 3a (49.2 %). Optimal cytoreduction was performed in 35.5 % of patients, 84.7 % of patients survived for one year, 44.1 % three years and 37.3 % for five years. The median survival was 26.25 months (range 0-91). Chi-square test showed significant difference between the number of months of survival and: the value of CA125 (t = 2.004, p = 0.050), cytoreduction (p < 0.001) and FIGO stage (p < 0.01). Conclusion: According to the results of this study, optimal cytoreduction and FIGO stage significantly influence survival (p < 0.001). Optimal cytoreduction (< 2 cm of residual disease) had the highest prognostic value for survival. A total five-year survival in this study was 37.3 %.

scholarly journals Does 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

2020 ◽  
Vol 09 (01) ◽  
pp. 30-33 ◽  
Author(s):  
Monisha Gupta ◽  
Shilpa Mukesh Patel ◽  
Ruchi Arora ◽  
Rajneesh Tiwari ◽  
Pariseema Dave ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Progression Free Survival ◽  
Survival Outcome ◽  
Complete Cytoreduction ◽  
Ca 125 ◽  
Survival Outcomes ◽  
Advanced Stage ◽  
Patient Counseling ◽  
Before And After

Abstract 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) and >95% (R > 95) fall from prechemotherapy to preoperative levels. Similarly, women were also categorized using preoperative CA-125 levels of <100 and >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. As compared to R < 95, 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 (P = 0.009) but no difference in overall survival (OS) (P = 0.28). Women with preoperative CA-125 <100 had significant higher number of complete cytoreduction (55% vs. 40%; P = 0.00) and were associated with both PFS (P = 0.007) and OS benefit (P = 0.02). Conclusion: Our data showed that >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.

Sign in / Sign up

Export Citation Format

Share Document