The Biological Tumor Markers' Myopia: A Model with CA 125 and Second-look in Ovarian Cancer

1987 ◽  
Vol 2 (2) ◽  
pp. 105-108 ◽  
Author(s):  
Flavia Zanaboni ◽  
Giuseppe Accinell ◽  
Pietro Colombo ◽  
Giorgio Jelmoni ◽  
Cesare Morandi ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Predictive Value ◽  
Disease Status ◽  
Residual Tumor ◽  
Tumor Burden ◽  
Epithelial Ovarian Carcinoma ◽  
Ca 125 ◽  
Biological Tumor Markers ◽  
Second Look ◽  
Second Look Operation

Preoperative CA 125 levels were measured in 36 patients with advanced epithelial ovarian carcinoma in clinical response undergoing a second-look operation. All the patients had positive levels (> 35 U/ml) of this tumor marker at diagnosis. The correlation between antigen levels and disease status at surgery revealed a sensitivity of this assay of 0.55 (only 11/20 patients still with tumor had positive levels) and a specificity of 0.94 (15/16 patients with no tumor had < 35 U/ml). The predictive value of a positive test was 0.92. This method unfortunately proved unable to recognize microscopic residual tumor burden, less than 0.5 cm.

Is there a CA-125 level that predicts negative second look surgery (SLS) in patients with advanced epithelail ovarian cancer (EOC)?

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 15042-15042
Author(s):  
S. Sharma ◽  
P. Singhal ◽  
K. Odunsi ◽  
S. Lele
Keyword(s):  
Ovarian Cancer ◽  
Disease Free Survival ◽  
Disease Status ◽  
Primary Treatment ◽  
Ca 125 ◽  
Primary Therapy ◽  
Second Look ◽  
Kaplan Meier ◽  
Response To Chemotherapy ◽  
Disease Free

15042 Background: The value of second look surgery (SLS) in advanced epithelial ovarian cancer (EOC) has been has been questioned because performing this procedure has not been associated with a clear survival advantage.However, SLS continues to be the most accurate means of documenting the response to chemotherapy, and therfore still used in investigational protocols. The primary purpose of this study was to assess the levels of CA 125 after treatment, that could predict absence of disease at SLS. Methods: Between 1998 and 2003, 98 stage III EOC patients who underwent optimal cytoreductive surgery, completed 6 cycles of platinum/paclitaxel chemotherapy, and were NED (no evidence of disease: normal CA 125, normal physical and radiological examination) were included in this study. SLS was performed at 6–8 weeks from completion of primary therapy. Patients with disease present at SLS were considered to have persistent disease and received second line chemotherapy. Patient demographics, surgical and chemotherapy treatments, and CA 125 levels prior to start and at completion of primary treatment were collected retrospectively. Survival was estimated by the Kaplan-Meier method. Results: Forty seven out of 98 (48%) of optimally debulked patients who were NED at completion of primary therapy underwent SLS. Twenty-five out of 47 patients (53%) had evidence of disease at SLS and 22 out of 47 patients (47%) were NED at SLS. The median disease free survival was 42 months (95% CI 16, 81) in patients with negative SLS compared with 17 months (95% CI 9, 45) in patients who did not undergo SLS (p = 0.03). Estimated 5-year survival in patients with negative SLS was 90% compared to 50% in patients who did not undergo SLS (p = 0.05). CA 125 levels of ≤ 10 after completion of primary therapy was predictive of negative SLS (p < 0.05). Conclusions: SLS evaluation of disease status appears to be a more accurate than standard clinical evaluation in patients who are NED at completion of their primary therapy. Negative SLS also appears to be a predictor of improved disease free and overall survival. Furthermore, CA 125 ≤ 10 is predictive of negative SLS in patients who are NED after completion of primary therapy. No significant financial relationships to disclose.

Predictive value of CA 125 antigen levels in second-look procedures for ovarian cancer

1985 ◽  
Vol 151 (7) ◽  
pp. 981-986 ◽  
Author(s):  
Jonathan M. Niloff ◽  
Robert C. Bast ◽  
Elena M. Schaetzl ◽  
Robert C. Knapp
Keyword(s):  
Ovarian Cancer ◽  
Predictive Value ◽  
Ca 125 ◽  
Second Look ◽  
Ca 125 Antigen

Measurement of the ovarian cancer-associated antigen CA 125 prior to second look operation

1988 ◽  
Vol 24 (12) ◽  
pp. 1835-1837 ◽  
Author(s):  
Ole Mogensen ◽  
Bent Mogensen ◽  
Anders Jakobsen ◽  
Arne Sell
Keyword(s):  
Ovarian Cancer ◽  
Ca 125 ◽  
Second Look ◽  
Second Look Operation

Nuclear morphometry: a strong prognostic factor for survival after secondary surgery in advanced ovarian cancer

1992 ◽  
Vol 2 (4) ◽  
pp. 198-206 ◽  
Author(s):  
T. HÖGberg ◽  
G. Wang ◽  
B. Risberg ◽  
C. Guerrieri ◽  
J. Hittson ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Advanced Ovarian Cancer ◽  
Residual Tumor ◽  
Figo Stage ◽  
Prognostic Information ◽  
Primary Operation ◽  
Nuclear Morphometry ◽  
Second Look ◽  
Cox Analysis ◽  
Second Look Operation

Nuclear morphometry was performed on the diagnostic biopsy in 65 cases of non-mucinous ovarian carcinoma (FIGO stage IIB–IV) and its prognostic value regarding patient survival after the second-look operation was compared to that of morphology and clinical observations. In a univariate Cox survival analysis four morphometric factors were found to be significant predictors of survival (the standard deviations (SD) of the nuclear area, perimeter, largest perpendicular axis, and largest axis). Age, the size of residual tumor after the primary operation, and a combined variable describing the status at the second-look operation and also the result of tumor reduction were significant clinical variables. None of the morphologic variables proved to be significant. In the multivariate Cox analysis the SD of the largest perpendicular nuclear axis gave independent prognostic information together with either the size of residual tumor after the primary laparotomy (P= 0.00004) or the second-look variable (P< 0.00001). When the SD of the largest perpendicular nuclear axis and the second-look variables were included in the model the size of residual tumor after the primary operation added no further prognostic information. We conclude that nuclear morphometry is a simple, easily implemented and cheap quantitative method which gives objective and valuable prognostic information regarding survival in advanced ovarian cancer.

Predictive value of serial CA 125 antigen levels in ovarian cancer evaluated by second-look laparotomy

1987 ◽  
Vol 23 (6) ◽  
pp. 765-771 ◽  
Author(s):  
Soo Keat Khoo ◽  
Terry Hurst ◽  
Maurice J. Webb ◽  
Graeme J. Dickie ◽  
John H. Kearsley ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Predictive Value ◽  
Ca 125 ◽  
Second Look ◽  
Ca 125 Antigen

The prognostic implications of low serum CA 125 levels prior to the second-look operation for stage III and IV epithelial ovarian cancer

1992 ◽  
Vol 46 (1) ◽  
pp. 29-32 ◽  
Author(s):  
H.H. Gallion ◽  
J.E. Hunter ◽  
J.R. van Nagell ◽  
H.E. Averette ◽  
J.M. Cain ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Stage Iii ◽  
Ca 125 ◽  
Second Look ◽  
Prognostic Implications ◽  
Second Look Operation ◽  
Low Serum

scholarly journals Automated Assay of a Four-Protein Biomarker Panel for Improved Detection of Ovarian Cancer

Cancers ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 325
Author(s):  
Christopher Walker ◽  
Tuan-Minh Nguyen ◽  
Shlomit Jessel ◽  
Ayesha B. Alvero ◽  
Dan-Arin Silasi ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Early Detection ◽  
Predictive Value ◽  
Early Stage ◽  
Ca 125 ◽  
Healthy Controls ◽  
Classification Models ◽  
Serum Samples ◽  
Protein Biomarker ◽  
Biomarker Panel

Background: Mortality from ovarian cancer remains high due to the lack of methods for early detection. The difficulty lies in the low prevalence of the disease necessitating a significantly high specificity and positive-predictive value (PPV) to avoid unneeded and invasive intervention. Currently, cancer antigen- 125 (CA-125) is the most commonly used biomarker for the early detection of ovarian cancer. In this study we determine the value of combining macrophage migration inhibitory factor (MIF), osteopontin (OPN), and prolactin (PROL) with CA-125 in the detection of ovarian cancer serum samples from healthy controls. Materials and Methods: A total of 432 serum samples were included in this study. 153 samples were from ovarian cancer patients and 279 samples were from age-matched healthy controls. The four proteins were quantified using a fully automated, multi-analyte immunoassay. The serum samples were divided into training and testing datasets and analyzed using four classification models to calculate accuracy, sensitivity, specificity, PPV, negative predictive value (NPV), and area under the receiver operating characteristic curve (AUC). Results: The four-protein biomarker panel yielded an average accuracy of 91% compared to 85% using CA-125 alone across four classification models (p = 3.224 × 10−9). Further, in our cohort, the four-protein biomarker panel demonstrated a higher sensitivity (median of 76%), specificity (median of 98%), PPV (median of 91.5%), and NPV (median of 92%), compared to CA-125 alone. The performance of the four-protein biomarker remained better than CA-125 alone even in experiments comparing early stage (Stage I and Stage II) ovarian cancer to healthy controls. Conclusions: Combining MIF, OPN, PROL, and CA-125 can better differentiate ovarian cancer from healthy controls compared to CA-125 alone.

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