scholarly journals RATIO OF SERUM CA125 TO RADIOLOGICAL PERITONEAL CARCINOMATOUS INDEX AS A NOVEL MARKER OF RESPONSE TO NEO ADJUVANT CHEMOTHERAPY AND PREDICTIVE MODEL OF SURGICAL OUTCOME IN ADVANCED EPITHELIAL OVARIAN CANCER- A SINGLE INSTITUITIONAL STUDY.

2020 ◽  
pp. 1-3
Author(s):  
Prem Kumar Devdoss ◽  
Prasanna Srinivasa Rao H ◽  
N. Roobalakshmi
Keyword(s):  
Ovarian Cancer ◽  
Adjuvant Chemotherapy ◽  
Neoadjuvant Chemotherapy ◽  
Epithelial Ovarian Cancer ◽  
Ca 125 ◽  
Newly Diagnosed ◽  
Response To Chemotherapy ◽  
Serum Ca125 ◽  
Advanced Epithelial Ovarian Cancer ◽  
Neo Adjuvant Chemotherapy

Objective: The objective of this retrospective study is to develop a novel marker- ratio of serum CA 125 to peritoneal carcinomatous index(PCI) - to predict the response in women receiving neoadjuvant chemotherapy for newly diagnosed advanced epithelial ovarian cancer at our centre. Methods: Medical records of women who were newly diagnosed with inoperable advanced ovarian cancer stages III and IV at our centre were selected. Only people with completely documented records in the years 2017 & 2018 were selected. Only patietns with serous histology were chosen. Pre chemotherapy serum CA125 value was noted. Radiological PCI was calculated by reviewing the CECT films & reports of the patients. Patients were compared with the ratio of CA125 to radiological PCI and clinical & pathological response to neo adjuvant chemotherapy. All patients received standard doses of three weekly Paclitaxel and Carboplatin based chemotherapy. Based on the ratio of CA125 to PCI patients were divided into 2 groups – ratio more than 100 and less than 100. Results: A total of 34 were patients were found to meet the eligible criteria. Response assessment was done after 3 to 4 cycles of neoadjuvant chemotherapy. The overall response rate to neoadjuvant chemotherapy in patients in group 1 ( CA125/PCI ratio > 100) was significantly higher as compared to patients in group 2 (CA125/PCI ratio <100). Conclusion: In summary, CA 125 to PCI ratio is novel method to predict response to chemotherapy in advanced epithelial ovarian cancers. This value is a helpful measurement that allows the clinicians to measure the degree of chemosensitivity prior to cytoreductive surgery. This measures the inherent tumor biology and to aids in surgical decision making regarding the role and extent of cytoreduction as well as alternate systemic/local therapies.

scholarly journals Dynamic analysis of serum Ca-125 levels during neoadjuvant chemotherapy in patients with advanced epithelial ovarian cancer: a retrospective study

2020 ◽  
Vol 10 (1) ◽  
pp. 88
Author(s):  
Adarsh Dharmarajan ◽  
A. Remya ◽  
Aswathi Krishnan
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Proportional Hazards ◽  
Disease Free Survival ◽  
Ca 125 ◽  
Free Survival ◽  
Proportional Hazards Regression ◽  
Response To Chemotherapy ◽  
Neo Adjuvant Chemotherapy ◽  
Disease Free

Background: Assessment of CA-125 kinetics was commonly used as a tool for tumor response to chemotherapy in ovarian cancer patients. The study aimed to determine any logarithmic/linear relationship between pre-chemotherapy and pre-operative CA-125 levels in ovarian cancer.Methods: Total 52 patients who underwent neoadjuvant chemotherapy (NACT) followed by interval cytoreductive surgery were included. CA-125 levels before starting chemotherapy, during chemotherapy and the preoperative value, with the date of measurement recorded. Cox’s proportional hazards regression was used to evaluate univariate and independent multivariable association with the effect of clinical, pathological and CA-125 kinetic parameters on outcome endpoints.  Results: The study couldn’t establish any relationship in logarithmic fall of CA-125 values among ovarian cancers as a result of neo-adjuvant chemotherapy. The disease-free survival among the patients was 12.2 months.Conclusions: There is an inverse relationship between serum CA-125 levels and survival in ovarian cancer. NACT resulted in adequate fall of CA-125 levels in most of the patients, but the rate of fall was not predictive of prognosis.

Serum HE4 Profile During Primary Chemotherapy of Epithelial Ovarian Cancer

2011 ◽  
Vol 21 (9) ◽  
pp. 1573-1578 ◽  
Author(s):  
Johanna Hynninen ◽  
Annika Auranen ◽  
Kirsti Dean ◽  
Maija Lavonius ◽  
Olli Carpen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Epithelial Ovarian Cancer ◽  
Serum Biomarker ◽  
Primary Chemotherapy ◽  
Ca 125 ◽  
Chemotherapy Response ◽  
Primary Therapy ◽  
Response To Chemotherapy

ObjectiveHuman epididymis protein 4 (HE4) is a promising novel serum biomarker for the detection of early-stage epithelial ovarian cancer (EOC) and for the differential diagnosis between benign and malignant ovarian tumors. The objective of the present study was to determine the value of HE4 for monitoring the response to primary therapy in patients with advanced disease.MethodsSerum HE4 and cancer antigen (CA) 125 levels of 10 patients with advanced EOC and one patient with adenocarcinoma of unknown origin were measured preoperatively and during first-line chemotherapy. Seven patients were treated with primary surgery and six cycles of chemotherapy. Response to treatment was evaluated 4 weeks after the completion of chemotherapy using computed tomography. Four patients received neoadjuvant chemotherapy (NACT) before surgery. To evaluate the early response to chemotherapy, changes in serum biomarker levels were compared with metabolic changes of tumors during NACT as detected by positron emission tomography/computed tomography.ResultsThe profile of HE4 during primary chemotherapy was in line with radiologic and clinical responses. In the neoadjuvant chemotherapy group, HE4 correlated better with the radiologic response than CA 125.ConclusionAssessment of serum HE4 may improve the reliability of response evaluation during chemotherapy for serous epithelial ovarian cancer.

Venous thromboembolism in advanced ovarian cancer patients undergoing front-line adjuvant chemotherapy.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 5570-5570
Author(s):  
Alok Pant ◽  
Julian C. Schink
Keyword(s):  
Ovarian Cancer ◽  
Venous Thromboembolism ◽  
Adjuvant Chemotherapy ◽  
Epithelial Ovarian Cancer ◽  
Bowel Resection ◽  
Prognostic Significance ◽  
Advanced Ovarian Cancer ◽  
Ca 125 ◽  
Front Line ◽  
Advanced Epithelial Ovarian Cancer

5570 Background: To define the incidence and prognostic significance of venous thromboembolism (VTE) in patients with advanced, epithelial ovarian cancer undergoing front-line adjuvant chemotherapy after extended period (28 day) post-operative prophylaxis. Methods: A retrospective analysis of patients with advanced, epithelial ovarian cancer who underwent surgery and chemotherapy at a single institution from January 2008 through December 2011 was performed. Exclusion criteria were prior history of VTE, VTE during the post-operative period, clear cell histology, use of anti-coagulation for a different indication, and lack of compliance with 28 days of post-operative prophylaxis with a low molecular weight heparin. Results: 128 patients met criteria for inclusion. Sixteen patients had a reported VTE during the time they were on front line chemotherapy (12.5%). Nine patients (7%) had a pulmonary embolus (PE) and 8 (6.3%) had a deep vein thrombus (DVT). The average BMI in the group that developed VTE was 28 and in the group without VTE was 26.5 (p = 0.23). Three out of 16 (23%) patients who developed VTE had undergone a suboptimal cytoreduction compared to 12/112 (11%) in the group with no VTE (p = 0.4). Six of the 16 (37%) patients who developed VTE during chemotherapy underwent a bowel resection and/or splenectomy during their cytoreductive surgery compared to 18 of 112 (16%) patients who did not develop VTE (p=0.079). Eight of the patients in the VTE group had indwelling venous catheters during chemotherapy (50%) compared to 39 (35%) in the group with no VTE (p = 0.27). In the group that developed VTE, there was a trend towards increased pre-operative CA-125, higher rates of bowel resection and/or splenectomy during surgery, decreased use of aspirin, and inferior survival. On multivariate analysis, patients who developed VTE had significantly longer post-operative hospital stays (7 vs 5 days [p = 0.009]) and lower rates of complete response (p = 0.01). Conclusions: A 12.5% risk of VTE merits consideration of prophylaxis during chemotherapy in this cohort. A randomized, controlled trial is needed to clarify whether the benefits of long term prophylaxis outweigh the risks and costs of such therapy.

Venous Thromboembolism in Advanced Ovarian Cancer Patients Undergoing Frontline Adjuvant Chemotherapy

2014 ◽  
Vol 24 (6) ◽  
pp. 997-1002 ◽  
Author(s):  
Alok Pant ◽  
Dachao Liu ◽  
Julian Schink ◽  
John Lurain
Keyword(s):  
Ovarian Cancer ◽  
Venous Thromboembolism ◽  
Adjuvant Chemotherapy ◽  
Epithelial Ovarian Cancer ◽  
Bowel Resection ◽  
Prognostic Significance ◽  
Ca 125 ◽  
Imaging Studies ◽  
Postoperative Prophylaxis ◽  
Advanced Epithelial Ovarian Cancer

ObjectiveThe aim of this study was to define the incidence and prognostic significance of venous thromboembolism (VTE) in patients with advanced, epithelial ovarian cancer undergoing frontline adjuvant chemotherapy after an extended period (28 days) of postoperative prophylaxis.MethodsA retrospective analysis of patients with advanced, epithelial ovarian cancer who underwent surgery and chemotherapy at a single institution from January 2008 through December 2011 was performed. Exclusion criteria were history of VTE, VTE during the postoperative period, clear cell histology, use of anticoagulation for a different indication, and lack of compliance with 28 days of postoperative prophylaxis with a low-molecular-weight heparin. Baseline patient demographics and oncologic outcomes were analyzed. Clinically symptomatic VTE was identified and confirmed with imaging studies. Otherwise, VTE was identified on imaging studies done to assess disease status at the conclusion of adjuvant chemotherapy.ResultsOne hundred twenty-eight patients met criteria for inclusion. Sixteen patients had a reported VTE during the time they were on frontline chemotherapy (12.5%). Nine patients (7%) had a pulmonary embolus, and 8 (6.3%) had a deep vein thrombus. The mean BMI in the group that developed VTE was 28, and in the group without VTE, it was 26.5 (P = 0.23). Three (23%) of the 16 patients who developed VTE had undergone a suboptimal cytoreduction compared with 12 (11%) of the 112 in the group with no VTE (P = 0.4). Six (37%) of the 16 patients who developed VTE during chemotherapy underwent a bowel resection and/or splenectomy during their cytoreductive surgery compared with 18 (16%) of the 112 patients who did not develop VTE (P = 0.079). Eight of the patients in the VTE group had indwelling venous catheters during chemotherapy (50%) compared with 39 (35%) in the group with no VTE (P = 0.27). In the group that developed VTE, there was a trend toward increased preoperative CA-125, higher rates of bowel resection and/or splenectomy during surgery, decreased use of aspirin, and inferior survival. On multivariate analysis, patients who developed VTE had significantly longer postoperative hospital stays (7 vs 5 days [P = 0.009]) and lower rates of complete response (P = 0.01).ConclusionsA 12.5% risk for VTE merits consideration of prophylaxis during chemotherapy in this cohort. A randomized, controlled trial is needed to clarify whether the benefits of long-term prophylaxis outweigh the risks and costs of such therapy.

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