Clinical Significance of Preoperative Serum Levels of CA 125 and TAG-72 in Ovarian Carcinoma

1997 ◽  
Vol 12 (3) ◽  
pp. 112-117 ◽  
Author(s):  
A. Gonzalez ◽  
F. Vizoso ◽  
J. Vázquez ◽  
A. Ruibal ◽  
J.L. Balibrea
Keyword(s):  
Overall Survival ◽  
Ovarian Carcinoma ◽  
Residual Disease ◽  
Residual Tumor ◽  
Serum Levels ◽  
Ca 125 ◽  
Preoperative Serum ◽  
Poor Differentiation ◽  
Well Differentiated ◽  
A Prospective Study

In a prospective study we evaluated in 48 patients with primary ovarian carcinoma the prognostic value of the preoperative circulating serum levels of CA 125 and TAG-72. Serum levels of CA 125 were above the cutoff level of 35 U/ml in 68% of patients, TAG-72 levels were higher than 6 U/ml in 50% of patients, while the simultaneous use of the two markers increased the sensitivity to 75%. Pretreatment CA 125 and TAG-72 levels were significantly lower (p < 0.05, for both) in patients with well differentiated tumors than in those with moderate or poor differentiation. Similarly, both marker levels were significantly higher (p < 0.001) in patients with residual disease after cytoreductive surgery than in those with no residual tumor. In addition, the CA 125 levels were also higher in initial stages (I-II) than in more advanced stages (III-IV) (p < 0.05), whereas TAG-72 levels were higher (p < 0.05) in patients with mucinous or endometrioid tumors than in those with serous carcinomas. The results further indicated that high preoperative serum levels of CA 125 and TAG-72 were associated with a shorter overall survival (p < 0.001 and p < 0.01, respectively). Finally, separate Cox multivariate analysis showed that preoperative CA 125 and TAG-72 serum levels were, after stage, the strongest factors to predict overall survival (p < 0.0001, p < 0.05 and p < 0.005, respectively) in patients with ovarian carcinoma.

Evaluation of serum CA 125 level as a tumor marker in borderline tumors of the ovary

1993 ◽  
Vol 3 (5) ◽  
pp. 299-303 ◽  
Author(s):  
C. G. TropÉ ◽  
A. Ph. Makar ◽  
J. Kærn ◽  
G. B. Kristensen ◽  
I. Vergote ◽  
...  
Keyword(s):  
Tumor Marker ◽  
Residual Disease ◽  
Elevated Serum ◽  
Residual Tumor ◽  
Ca 125 ◽  
Disease Evolution ◽  
Second Look ◽  
Preoperative Serum ◽  
Significant Difference ◽  
Postoperative Serum

Serum CA 125 was evaluated as a tumor marker in 85 patients with borderline ovarian tumors. Serum CA 125 levels were elevated preoperatively in 18 of 20 (90%) samples (median 66, range 5–272 U ml−1). Preoperative serum CA 125 levels did not correlate to FIGO stage. Preoperative serum CA 125 levels were elevated in seven of nine (78%) with serous tumors (median 131, range 5–272 U ml−1) and in all 11 with mucinous tumors (median 62, range 41–157 U ml−1). There was no significant difference in the CA 125 levels between these two histologic types. Postoperative serum CA 125 levels, measured 3–6 weeks after primary laparotomy, were significantly lower than the preoperative ones (P< 0.001). No difference in the postoperative CA 125 levels was found between those with and those without residual disease after surgery. Postoperative serum CA 125 levels were elevated in eight of 60 (13%) without residual tumor. None of these had relapsed at the time of analysis (26–87 months after surgery). Serum CA 125 levels tended to correlate with disease evolution during chemotherapy. Two with disease remissions had falling levels, one with stable disease had falling level and one with disease progression had rising level. Serum CA 125 samples were obtained before second-look laparotomy in seven patients. Two with negative findings at second-look had normal levels. Of five with positive findings at laparotomy only two had elevated serum CA 125 levels. Disease relapse was associated with elevated serum CA 125 levels in only one of six patients.

Preoperative CEA and TAG-72 Serum Levels as Prognostic Indicators in Resectable Gastric Carcinoma

1996 ◽  
Vol 11 (3) ◽  
pp. 165-171 ◽  
Author(s):  
A. González ◽  
F. Vizoso ◽  
M.T. Allende ◽  
M.T. Sánchez ◽  
J.L. Balibrea ◽  
...  
Keyword(s):  
Overall Survival ◽  
Gastric Carcinoma ◽  
Serum Levels ◽  
Stage I ◽  
Stage Ii ◽  
Prognostic Indicators ◽  
Survival Duration ◽  
Preoperative Serum ◽  
Poorly Differentiated ◽  
Well Differentiated

We evaluated in 74 patients with resectable primary gastric carcinoma, the prognostic value of the preoperative circulating serum levels of CEA and TAG-72. Serum levels of CEA were above the cutoff level of 6 ng/ml in 18.9% of patients; TAG-72 levels were higher than 6 U/ml in 31% of patients. Pretreatment mean CEA levels were significantly lower (p<0.01) in patients with stage I tumors (2.9 ± 0.3 ng/ml) than in those with more advanced tumors (stage II: 14.5 ± 6.8 ng/ml; stage HI-TV: 6.8 ± 1.5 ng/ml). Similarly, significant differences in mean TAG-72 serum levels were found between stage I (3.5 ± 1.8 U/ml) and stage II and stage III-IV (30.4 ± 20.7 U/ml and 26.1 ± 9.7 U/ml, respectively) (p<0.05). In addition, TAG-72 levels were also higher in poorly differentiated and moderately differentiated tumors (38.5 ± 20.1 U/ml and 23.1 ± 9.4 U/ml, respectively) than in well differentiated tumors (4.4 ± 0.9 U/ml) (p<0.05). The results further indicated that high preoperative serum levels of CEA predicted shorter relapse-free survival duration (p<0.01), and that high TAG-72 levels were associated with shorter relapse-free and overall survival (p < 0.0001 and p < 0.0005, respectively). In addition, separate Cox multivariate analysis showed that preoperative TAG-72 was, after stage, the strongest factor to predict both relapse-free and overall survival (p < 0.0001 and p < 0.005, respectively) in patients with gastric cancer.

Clinical and diagnostic aspects of deep infiltrative endometriosis (diagnosis, treatment, recurrence)

GYNECOLOGY ◽  
2021 ◽  
Vol 23 (4) ◽  
pp. 307-313
Author(s):  
Shakhnoza K. Muftaidinova ◽  
Leonid Z. Faizullin ◽  
Vladimir D. Chuprynin ◽  
Nikolai S. Ruseikin ◽  
Tatiana I. Smolnova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hormonal Therapy ◽  
Serum Levels ◽  
Ca 125 ◽  
Prior History ◽  
Deep Endometriosis ◽  
Preoperative Serum ◽  
Peritoneal Endometriosis ◽  
History Of ◽  
Deep Infiltrative Endometriosis

Aim. To analyze the recurrence of endometriosis after surgical treatment of patients with deep endometriosis. Materials and methods. The case histories of 90 patients aged 19 to 45 years were retrospectively analyzed. The study group consisted of 70 endometriosis patients: 20 with peritoneal endometriosis and 50 with deep infiltrative endometriosis (DIЕ). The comparison group included 20 women without endometriosis. There was an in-depth study of anamnestic data in the cohort of patients under study. The results of preoperative laboratory tests, including serum levels of the CA-125 and CA 19-9 oncomarkers, were processed. Results. Analysis of the obtained data showed that about half of the DIE patients (54%) in the main group had a history of surgical interventions for endometriosis. The number of operations was significantly higher in patients compared to the peritoneal endometriosis group (68% vs 20%, respectively; р=0.0012). Two subgroups were formed from the group of women with DIE: patients who had no history of previous surgical treatment for endometriosis and those hospitalized for repeated surgical treatment of endometriosis (patients with recurrent endometriosis). Patients with recurrent endometriosis had a significantly higher incidence of heavy menstruation, pregnancy terminations (abortions), and a high proportion of gastrointestinal diseases. Analysis of the hormonal therapy received in patients with DIE showed that every second patient with relapses (18/53%) after surgical treatment and every third patient without a prior history of surgery (5/31%) received hormonal therapy. Examination of the preoperative serum levels of CA-125 and CA 19-9 serum markers in patients with DIE showed an increase in their serum levels and a correlation with the frequency of endometriosis recurrence and the size of DIE foci. Conclusion. Despite the conservative and surgical treatment of DIE patients, the recurrence rate is still high. At present, there is no satisfactory therapy for all endometriosis patients. Therefore, the development of therapy for the conservative treatment of the disease remains an urgent task.

Clinical Value of Radioimmunoscintigraphy in the follow-up of Ovarian Carcinoma: A Prospective Study

1990 ◽  
Vol 5 (3) ◽  
pp. 103-108 ◽  
Author(s):  
F. Crippa ◽  
M. Presti ◽  
A. Marini ◽  
B. D'Onofrio ◽  
G. Bolis ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Ovarian Carcinoma ◽  
Residual Tumor ◽  
Clinical Value ◽  
Second Look ◽  
Tumor Persistence ◽  
Upper Abdominal ◽  
Abdominal Lesions ◽  
A Prospective Study

Twenty-five patients treated with debulking surgery and chemotherapy for ovarian cancer were prospectively studied to evaluate the efficacy of radioimmunoscintigraphy (RIS) in detecting residual tumor before second-look surgery. RIS was performed with the monoclonal antibody OC125 F(ab')2 labelled with 1-131 without knowledge of clinical data and compared with subsequent surgical results. Second look showed tumor persistence in 12 patients, mostly characterized by small lesions. The overall diagnostic sensitivity of RIS was 50% and the specificity was 85%. In particular, RIS showed better sensitivity for pelvic tumor localizations than for abdominal sites (73% vs 33%); this was due to the inability of RIS to detect upper abdominal lesions. Therefore, our conclusion is that, at present, RIS cannot substitute surgical second-look in the management of ovarian cancer, however, considering that also ultrasonography, computer tomography and magnetic resonance are not always able to give definite diagnostic evidence in the follow-up of ovarian carcinoma, RIS could be added to these procedures to balance the limitations of each method. In this regard, the best application of RIS could be in the follow-up of patients with marker elevation without clinical evidence of disease, especially in the case of pelvic fibrosis or adhesions due to previous therapy, where the other non-invasive tools can give doubtful diagnostic results.

Surgical Treatment of Metastatic Ovarian Tumors From Extragenital Primary Sites

2016 ◽  
Vol 26 (4) ◽  
pp. 688-696 ◽  
Author(s):  
Veysel Sal ◽  
Fuat Demirkiran ◽  
Samet Topuz ◽  
Ilker Kahramanoglu ◽  
Ibrahim Yalcin ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Residual Disease ◽  
Univariate Analysis ◽  
Ovarian Metastasis ◽  
Ovarian Tumors ◽  
Ca 125 ◽  
Cancer Site ◽  
Primary Cancer ◽  
Preoperative Serum ◽  
Primary Cancer Site

ObjectiveThe purpose of this study was to investigate the outcomes and prognostic factors of metastasectomy in patients with metastatic ovarian tumors from extragenital primary sites.Materials and MethodsAll patients with pathologically confirmed metastatic ovarian tumors between January 1997 and June 2015 were included in this study. A total of 131 patients were identified. The data were obtained from the patients’ medical records. Clinicopathological features were evaluated by both univariate and multivariate analyses.ResultsThe primary sites were colorectal region (53.4%), stomach (26%), and breast (13%). Preoperative serum CA 125 and CA 19-9 levels were elevated in 29.4% and 39.8% of the patients, respectively. Cytoreductive surgery was performed in 41.2% of the patients. Seventy-three (55.7%) patients had no residual disease after surgery. Sixty-six (49.6%) patients had combined metastases at the time of the surgery to sites including the liver, pancreas, lung, bone, lymph nodes, bladder, or the intestine. With a median follow-up of 33 months, the median survival time was 22 months. The estimated 5-year survival probability is 0.26. On univariate analysis, primary cancer site, combined metastasis outside the ovaries, residual disease, preoperative serum CA 125 and CA 19-9 levels, and histologic type were significant parameters for overall survival. Furthermore, residual disease, preoperative serum CA 19-9 level, and primary cancer site were found to be independent prognostic factors on multivariate analysis.ConclusionsThe most common primary sites for ovarian metastasis are gastrointestinal tract. Metastasectomy may have beneficial effects on survival, especially if the residual disease is less than 5 mm. Prospective studies warranted to evaluate the value of metastasectomy in patients with ovarian metastasis.

Preoperative serum vascular endothelial growth factor as a prognostic parameter in ovarian cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10093-10093
Author(s):  
A. Reinthaller ◽  
P. Sevelda ◽  
L. A. Hefler
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Tumor Grade ◽  
Residual Tumor ◽  
Figo Stage ◽  
Tumor Mass ◽  
Prognostic Parameter ◽  
Primary Surgery ◽  
Preoperative Serum ◽  
Residual Tumor Mass

10093 Objective: Serum vascular endothelial growth factor (VEGF) levels have been shown to be associated with an adverse outcome in patients with ovarian cancer. We studied the clinical value of serum VEGF as an independent prognostic parameter. Methods: In the present study, we ascertained preoperative serum VEGF in a series of 314 patients with ovarian cancer. VEGF serum were evaluated in 45 new cases. Serum VEGF was evaluated prior to primary surgery in all patients. The re-analysis of previously published data comprised a total of 269 cases. Patients were treated between 1990 and 2003. Mean duration of follow-up was 38.9 (32.4) months. Patients with epithelial ovarian cancer were included into the present study, patients with other malignant ovarian tumors, borderline tumors, and benign adnexal masses were excluded. Serum VEGF was evaluated prior to primary surgery using an enzyme linked immunosorbent assay (Quantikine Human VEGF Immunoassay; R&D Systems, Minneapolis, MN) in all studies. Results were correlated with clinical data. Results: Median serum VEGF was 407 (238–746) pg/mL. Serum VEGF was associated with serum CA 125 (p=0.003) and residual tumor mass (p=0.02; residual tumor mass < 1cm: 375.5 [209.5–608.9] pg/mL vs. residual tumor mass ≥ 1cm: 625.2 [320.7–1046.7] pg/mL). Serum VEGF was not associated with FIGO stage (p=0.5), lymph node involvement (p=0.2), tumor grade (p=0.2), and patients’ age (p=0.08). In a univariate Kaplan-Meier analysis, FIGO stage, residual tumor mass, tumor grade, patients’ age, serum CA 125, and preoperative serum VEGF were associated with overall survival. In a multivariate Cox regression model, higher FIGO stage, presence of residual tumor mass after primary surgery, and higher serum VEGF were independently associated with a shortened overall survival. Planned subgroup analysis was performed for patients with ovarian cancer FIGO stage I. In a multivariate Cox regression model, higher tumor grade and higher serum VEGF were the only independent prognosticators for overall survival. Patients with FIGO stage I ovarian cancer and a serum VEGF ≥ 380 pg/mL had a 8-fold increased risk for experiencing cancer related death. Conclusion: Serum VEGF is an independent prognostic parameter in patients with all stages of ovarian cancer. No significant financial relationships to disclose.

The combination of intravenous bevacizumab and metronomic oral cyclophosphamide for recurrent platinum-resistant ovarian cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 5039-5039
Author(s):  
Emma L. Barber ◽  
Nikki Lynn Neubauer ◽  
Emese Zsiros ◽  
Julian C. Schink
Keyword(s):  
Overall Survival ◽  
Ovarian Carcinoma ◽  
Single Agent ◽  
Progression Free Survival ◽  
Complete Response ◽  
Response To Treatment ◽  
Ca 125 ◽  
Oral Cyclophosphamide ◽  
Free Survival ◽  
Platinum Resistant

5039 Background: This study was undertaken to determine the progression free survival and overall survival in heavily pre-treated patients with recurrent ovarian carcinoma treated with bevacizumab and metronomic oral cyclophosphamide. Methods: An IRB-approved retrospective review was performed for all patients with recurrent ovarian, fallopian tube or primary peritoneal carcinomas treated with intravenous bevacizumab 10mg/kg every 14 days and oral cyclophosphamide 50mg daily between January 2006 and December 2010. Response to treatment was determined by change in disease status according to RECIST criteria and/or CA-125 levels. Results: Sixty-six eligible patients were identified with a median age of 58 years. Fifty-five patients (83%) originally had optimal cytoreduction and all were platinum resistant. Median time from diagnosis to beginning bevacizumab and cyclophosphamide was 36 months. Median number of prior chemotherapy treatments was 7.5 (range 3-16). Eight patients (12.1%) had side effects which required discontinuing bevacizumab and cyclophosphamide, most common were hypertension, proteinuria, and fatigue. There was one bowel perforation (1.5%). A complete response was noted in 7 patients (10.6%), partial response was seen in 21 patients (31.8%) with an overall response rate of 42.4%. Fifteen patients (22.7%) had stable disease and 23 (34.8%) had disease progression. Median progression free survival (PFS) for responders was 5 months (range 2-14) and 11 months (range 4-14) for those with a complete response. Median overall survival (OS) from start of bevacizumab and cyclophosphamide for responders was 20 months (range 2-56) and 9 months (range 1-51) for nonresponders. Conclusions: Bevacizumab and cyclophosphamide is an effective, well-tolerated chemotherapy regimen in heavily pre-treated patients with recurrent ovarian carcinoma which significantly improves PFS and OS in responders. Response rates were significantly better than the rates we have reported in this same group of patients receiving topotecan (22%) or liposomal doxorubicin (25%) and were superior to reported rates for single agent bevacizumab (18%) in patients with only 2-3 prior regimens.

A contemporary analysis of the ability of preoperative serum CA-125 to predict primary cytoreductive outcome in patients with advanced ovarian, tubal, and peritoneal carcinoma

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 5572-5572 ◽  
Author(s):  
O. Zivanovic ◽  
D. S. Chi ◽  
E. L. Eisenhauer ◽  
Y. Sonoda ◽  
D. A. Levine ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Residual Disease ◽  
Tumor Grade ◽  
Ca 125 ◽  
Study Cohort ◽  
Peritoneal Carcinoma ◽  
Upper Abdominal Surgery ◽  
Preoperative Serum ◽  
Disease Site ◽  
Upper Abdominal

5572 Background: We previously reported that preoperative CA-125 may predict primary cytoreductive outcome in patients (pts) with stage III ovarian carcinoma. We performed a contemporary analysis of the ability of preop CA-125 to predict cytoreductive outcome in advanced ovarian, tubal and peritoneal carcinoma. Methods: In 1/01, we initiated a programmatic change in our primary surgical approach to advanced gynecologic malignancies using extensive upper abdominal procedures to achieve maximal cytoreduction. We reviewed the records of all pts with advanced ovarian, tubal or peritoneal carcinoma who underwent primary cytoreduction at our institution between 1/01 and 4/05. Results: The study cohort included 277 pts. Primary disease site was: ovary; 232 (84%); tubal, 9 (3%); and peritoneum, 36 (13%). Stage was: IIIA, 6 (2%); IIIB, 12 (4%); IIIC, 215 (78%); and IV, 44 (16%). Tumor grade was: I, 6 (2%); II, 30 (11%), III, 235 (85%), and unknown, 6 (2%). Cytoreductive outcome was: no gross residual disease (RD), 68 (25%); ≤ 1 cm RD, 153 (55%); and > 1 cm RD, 56 (20%). There was no threshold CA-125 level that accurately predicted cytoreductive outcome. With CA-125 values > 500 U/mL, 50% (57/113) of pts required extensive upper abdominal surgery to achieve RD ≤ 1 cm, compared to 27% (25/93) for those with CA-125 < 500 U/mL (P = 0.03). The table demonstrates the number of pts cytoreduced to = 1 cm RD in relation to preoperative serum CA-125 and the proportion of pts who needed extensive upper abdominal surgery to achieve this degree of cytoreduction. Conclusions: After the incorporation of extensive upper abdominal procedures, preop CA-125 did not predict the primary cytoreductive outcome of pts with advanced ovarian, tubal or peritoneal carcinoma. With preoperative CA-125 > 500 U/mL, extensive upper abdominal procedures were necessary in 50% of pts to achieve residual disease ≤ 1 cm. These data may be useful as part of preoperative surgical counseling and planning. [Table: see text] No significant financial relationships to disclose.

Sign in / Sign up

Export Citation Format

Share Document