scholarly journals Preoperative serum CA-125 level as a predictor for the extent of cytoreduction in patients with advanced stage epithelial ovarian cancer

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Sebastjan Merlo ◽  
Nikola Besic ◽  
Eva Drmota ◽  
Nina Kovacevic
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Progression Free Survival ◽  
Patient Characteristics ◽  
Serum Levels ◽  
Primary Treatment ◽  
Ca 125 ◽  
Advanced Stage ◽  
Debulking Surgery ◽  
Preoperative Serum

AbstractBackgroundOvarian cancer is the seventh most common cancer in women worldwide and the eighth most common cause of cancer death. Due to the lack of effective early detection strategies and the unspecific onset of symptoms, it is diagnosed at an advanced stage in 75% of cases. The cancer antigen (CA) 125 is used as a prognostic marker and its level is elevated in more than 85% of women with advanced stages of epithelial ovarian cancer (EOC). The standard treatment is primary debulking surgery (PDS) followed by adjuvant chemotherapy (ACT), but the later approach is neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS). Several studies have been conducted to find out whether preoperative CA-125 serum levels influence treatment choice, surgical resection and survival outcome. The aim of our study was to analyse experience of single institution as Cancer comprehensive center with preoperative usefulness of CA-125.Patients and methodsAt the Institute of Oncology Ljubljana a retrospective analysis of 253 women with stage FIGO IIIC and IV ovarian cancer was conducted. Women were divided into two groups based on their primary treatment. The first group was the NACT group (215 women) and the second the PDS group (38 women). The differences in patient characteristics were compared using the Chi-square test and ANOVA and the Kaplan-Meier method was used for calculating progression-free survival (PFS) and overall survival (OS).ResultsThe median serum CA-125 level was higher in the NACT group than in the PDS group, 972 IU/ml and 499 IU/ ml, respectively. The PFS in the NACT group was 8 months (95% CI 6.4–9.5) and 18 months (95% CI 12.5–23.4) in the PDS group. The median OS was lower in the NACT group than in the PDS group, 25 months (95% CI 20.6–29.5) and 46 months (95% CI 32.9–62.1), respectively.ConclusionsPreoperative CA-125 cut off value of 500 IU/ml is a promising threshold to predict a successful PDS.

scholarly journals High serum and ascitic soluble interleukin-2 receptor alpha levels in advanced epithelial ovarian cancer [see comments]

Blood ◽  
1993 ◽  
Vol 81 (2) ◽  
pp. 424-429 ◽  
Author(s):  
DP Barton ◽  
DK Blanchard ◽  
B Michelini-Norris ◽  
SV Nicosia ◽  
D Cavanagh ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Cancer Patients ◽  
Ascitic Fluid ◽  
Total Protein ◽  
Interleukin 2 ◽  
Serum Levels ◽  
Ca 125 ◽  
Soluble Interleukin 2 Receptor ◽  
Advanced Epithelial Ovarian Cancer

Abstract This study was undertaken to determine if advanced epithelial ovarian cancer was associated with increased serum and ascitic levels of soluble interleukin-2 receptor alpha (sIL-2R alpha). Serum and ascitic fluid samples from 23 ovarian cancer patients were analyzed for sIL-2R alpha using an enzyme-linked immunosorbent assay and compared with the serum and peritoneal levels in 18 normal females. The samples were analyzed for CA-125 levels using a radioimmunoassay and the total protein was also measured. Normal individuals had low serum levels of sIL-2R alpha (367.5 +/- 44.6 U/mL), with similar levels of sIL-2R alpha in the normal peritoneal fluid (438.6 +/- 48.8 U/mL). In contrast, the serum and ascitic fluid levels in ovarian cancer patients were significantly higher (746.7 +/- 82.9 U/mL, P = .0006; 2,656.7 +/- 373.7 U/mL, P = .00002, respectively). The results for sIL-2R alpha were also significant when the levels were expressed per milligram of total protein. More importantly, in almost every ovarian cancer patient the ascitic sIL-2R alpha level far exceeded the serum level, a pattern also observed for CA-125. There was no correlation between the serum and ascitic sIL-2R alpha levels, or between the serum and ascitic CA-125 levels. Although the serum levels of sIL-2R alpha and CA-125 were elevated in the same patient, overall there was no correlation between the serum sIL-2R alpha and serum CA-125 levels, either when the levels were expressed in absolute units or per milligram of total protein. Similarly, there was no correlation between sIL-2R alpha and CA-125 levels in individual ascitic samples. While CA-125 levels may reflect an independent index of tumor burden, these results suggest that selective accumulation of sIL-2R alpha in the ascites may be one of the factors associated with the known nonresponsiveness of the infiltrating lymphocytes against ovarian carcinoma cells.

Comparison of Standard and CA-125 Response Criteria in Patients With Epithelial Ovarian Cancer Treated With Platinum or Paclitaxel

1999 ◽  
Vol 17 (2) ◽  
pp. 501-501 ◽  
Author(s):  
John A. Bridgewater ◽  
Ann E. Nelstrop ◽  
Gordon J.S. Rustin ◽  
Martin E. Gore ◽  
William P. McGuire ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Stable Disease ◽  
Progression Free Survival ◽  
Response Rates ◽  
Response Criteria ◽  
Ca 125 ◽  
Free Survival ◽  
Median Progression Free Survival ◽  
Standard Response

PURPOSE: To assess CA-125 as a measure of response in patients treated with paclitaxel. PATIENTS AND METHODS: One hundred forty-four patients treated with paclitaxel derived from four different trials and 625 patients treated with platinum from two trials were analyzed using precisely defined 50% and 75% reductions in CA-125. The standard and CA-125 response rates to paclitaxel and platinum were compared. In addition, we analyzed individual patient groups in which there was a difference in response according to the two response criteria. RESULTS: Patients with stable disease as determined by standard criteria who were treated with platinum and responded according to CA-125 criteria have an improved median progression-free survival compared with patients with stable disease who did not respond according to CA-125 criteria (10.6 v 4.8 months; P < .001). Standard and CA-125 response rates for patients treated with platinum (58.93% v 61.31%, respectively) and paclitaxel (30.65% v 31.67%, respectively) were very similar, as were rates of false-positive prediction of response by CA-125 (platinum 2.2% and paclitaxel 2.9%). Responders to paclitaxel had a significantly improved progression-free survival compared with nonresponders by both standard criteria (median progression-free survival, 6.8 v 2.5 months; P < .001) and CA-125 criteria (median progression-free survival, 6.8 v 3.4 months; P < .001). CONCLUSION: For assessing activity of therapy for ovarian cancer, these data show that precise 50% or 75% CA-125 response criteria are as sensitive as standard response criteria. We propose that they may be used as a measure of response in lieu of or in addition to standard response criteria in clinical trials involving epithelial ovarian cancer. Sensitivity is maintained whether patients are treated with platinum or paclitaxel.

Prognostic significance of elevated pretreatment serum levels of CEA and CA-125 in epithelial ovarian cancer

2020 ◽  
Vol 28 (3) ◽  
pp. 285-292
Author(s):  
Yu-Han Lin ◽  
Chen-Hsuan Wu ◽  
Hung-Chun Fu ◽  
Yu-Jen Chen ◽  
Yin-Yi Chen ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Prognostic Significance ◽  
Serum Levels ◽  
Ca 125 ◽  
Pretreatment Serum

Early evaluation of response to neoadjuvant chemotherapy in stage IIIC-IV epithelial ovarian cancer patients by 18FDG-PET and CA 125: Preliminary findings from the Arianna Project 02

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 15039-15039
Author(s):  
N. Cacciari ◽  
S. Fanti ◽  
C. Zamagni ◽  
M. Rosati ◽  
F. Massari ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Ct Scan ◽  
Epithelial Ovarian Cancer ◽  
Standardized Uptake Value ◽  
Serum Levels ◽  
Ca 125 ◽  
Pelvic Mri ◽  
Early Evaluation ◽  
18Fdg Pet ◽  
Early Tumor

15039 Background: Early evaluation of response to primary chemotherapy (PSC) in epithelial ovarian cancer (EOC) pts could allow to administer a proper number of cycles in order to obtain optimal results. Arianna Project 02 is aimed to investigate early tumor response to PSC correlating a set of routine and experimental hystological, biological and gene-expression profile data with clinical data before, during and after PSC. Methods: Stage III-IV EOC received 6 cycles of carboplatin AUC 5 and paclitaxel 175 mg/m2 and are evaluated at baseline and before each cycle by 18FDG-PET, CA 125, circulating tumor cells and experimental circulating bio-markers. Ultrasounds, CT scan and pelvic MRI are done at baseline and every other cycle. This preliminary report is focused on the correlation between changes of PET and CA 125 serum levels and pathological response. Results: Up to now 6 out of 11 pts completed PSC and surgery. Baseline tumoral 18FDG uptake expressed as Standardized Uptake Value (SUV) and CA125 were abnormal in all pts (SUVmax range: 12.1–20; CA 125 range: 416–2026 U/ml, upper normal limit 35 U/ml). One complete and 4 partial pathological remissions > 90% and one no change were observed. Mean (with range) SUVmax and CA125 decrease (Δ SUV and Δ CA125) measured after the 1st, 2nd, 3rd and last cycle of PSC in the 5 responders are similar (table). In the non-responder SUV decreased by 63% after the 1st cycle of PSC, but increased to baseline value after the 2nd cycle and remained unchanged until surgery, while CA 125 progressively decreased from 416 U/ml to 47 U/ml. Conclusions: These preliminary findings indicate that the behaviour of PET and CA 125 in responders are similar. More data are necessary to define the role of PET in the early evaluation of response to PSC in EOC pts. The study is still ongoing and the relationship between evaluation performed by PET and CA125 and by CT scan, ultrasound and pelvic MRI will be presented at ASCO meeting. [Table: see text] No significant financial relationships to disclose.

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