Clinical significance of postoperative CA-125 level after primary cytoreductive surgery in ovarian cancer

e18046 Background: Although advances in chemotherapy, cytoreductive surgery, and maintenance therapy (SOC) improved PFS for high grade epithelial ovarian cancer, > 20% of patients relapse during the first 6 months and 60% relapse after 6 months. Submicron particles (~800 nm) of paclitaxel (SPP) contain 1-2 billion molecules of pure drug that release tumoricidal levels of paclitaxel over many weeks. In a previous trial, percutaneous instillations of SPP in nonsurgical patients with intraperitoneal cancer were associated with reduced systemic and local toxicity as compared to standard chemotherapy regimens. (Williamson et al Cancer Chemo Pharm (2015) 75:1075). Methods: This study compared two dose-levels of IP SPP instilled in 200 ml of saline post-cytoreductive surgery. Eligible patients with primary (n = 6) or recurrent (n = 4) epithelial ovarian cancer who underwent complete cytoreductive surgery were enrolled to receive a single instillation of IP SPP followed by standard IV carboplatin and paclitaxel. Endpoints were PFS and evaluation of treatment-emergent adverse events. Clinical response was determined by CT scans and serum CA-125 measurements. Results: Of the 24 subjects screened, 10 were enrolled and received treatment: seven patients received 100 mg/m2 and three received 200 mg/m2. For analysis purposes, 7 out of 10 subjects were evaluable (1 withdrew, 1 died unrelated to study drug during IV treatment and 1 was unevaluable). Upon completion of planned chemotherapy post-SPP instillation, the PFS at 6 months was 66% (4/6) and at 12-months 66% (4/6) using RECIST 1.1. One subject had a complete response at the end of IV treatment, but died (unrelated to study treatment) before PFS evaluation. There was one case of incision dehiscence and one case of vaginal cuff leakage after surgery. Conclusions: This pilot study supports further evaluation of IP SPP to treat peritoneal carcinomas. Clinical trial information: NCT03029585.

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Optimisation of Cytoreductive Surgery in Relation to Ca 125 in Epithelial Ovarian Cancer

Indian Journal of Gynecologic Oncology ◽

10.1007/s40944-018-0181-1 ◽

2018 ◽

Vol 16 (1) ◽

Author(s):

K. Shobha ◽

Natarajan Jayashree ◽

U. D. Bafna

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Cytoreductive Surgery ◽

Ca 125

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Percutaneous Radiofrequency Ablation Combined With Chemotherapy Versus Chemotherapy Only for Ovarian Cancer Liver Metastasis

Frontiers in Oncology ◽

10.3389/fonc.2021.793024 ◽

2022 ◽

Vol 11 ◽

Author(s):

Chun-Xue Wu ◽

Miao-Ling Chen ◽

Hao Zhang ◽

Jian-Jun Han

Keyword(s):

Ovarian Cancer ◽

Overall Survival ◽

Retrospective Study ◽

Radiofrequency Ablation ◽

Liver Metastasis ◽

Cytoreductive Surgery ◽

Ca 125 ◽

Percutaneous Radiofrequency Ablation ◽

Chemotherapy Group ◽

Effective Option

PurposeTo compare the feasibility and efficacy of radiofrequency ablation (RFA) combined with chemotherapy and chemotherapy alone in patients with ovarian cancer liver metastasis (OCLM).MethodsIn this retrospective study, a total of 60 patients diagnosed with OCLM between May 2015 to February 2017 were included. All patients with ovarian cancer received chemotherapy and primary cytoreductive surgery before. Thirty patients underwent RFA and chemotherapy, and thirty patients only took chemotherapy. The overall survival (OS), CA-125 levels, and serum AST and ALT levels were compared between the two groups.ResultsIn the RFA group, the 1-,2-, and 3-year OS rates after RFA were 93.3%, 80.0%, and 53.3%, respectively. Serum AST and ALT levels were both elevated after RFA (p=0.0004, p<0.0001). In the chemotherapy group, the 1-,2-, and 3-year OS rates were 79.5%, 60.1%, and 42.1%, respectively. Levels of serum AST and ALT were stable. CA-125 levels for both groups were also available.ConclusionBased on our analysis of a single institution’s series of patients with OCLM, RFA could be a feasibly effective option in the management of OCLM.

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The clinical significance of pre-operative serum CA 125 in ovarian cancer

International Journal of Gynecology & Obstetrics ◽

10.1016/0020-7292(88)90386-4 ◽

1988 ◽

Vol 26 (3) ◽

pp. 476-476

Author(s):

D.J. Cruickshank ◽

W.T. Fullerton ◽

A Klopper

Keyword(s):

Ovarian Cancer ◽

Clinical Significance ◽

Ca 125

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Ovarian metastasis from nongynecologic primary sites: a retrospective analysis of 177 cases and 13-year experience

Journal of Ovarian Research ◽

10.1186/s13048-020-00714-8 ◽

2020 ◽

Vol 13 (1) ◽

Author(s):

Jing-Jing Zhang ◽

Dong-Yan Cao ◽

Jia-Xin Yang ◽

Keng Shen

Keyword(s):

Ovarian Cancer ◽

Adjuvant Treatment ◽

Cytoreductive Surgery ◽

Ovarian Metastasis ◽

Primary Site ◽

Prognostic Indicators ◽

Ca 125 ◽

College Hospital ◽

Primary Ovarian Cancer ◽

Postoperative Adjuvant Treatment

Abstract Background Metastasis to the ovary from nongynecologic organs accounts for 9% of all ovarian malignancies. Although the most common nongynecologic primary site of ovarian metastasis is the gastrointestinal tract, metastasis from other sites to the ovary is not uncommon. Differential diagnosis of primary and metastatic ovarian tumors is important; otherwise, appropriate treatment cannot be determined. Furthermore, an optimal treatment strategy for ovarian metastasis from nongynecologic primary sites still needs to be explored. Methods One hundred seventy-seven patients with ovarian metastasis from nongynecologic primary sites admitted to Peking Union Medical College Hospital between May 2005 and May 2018 were retrospectively evaluated. Results The mean age was 48 years (range, 18–83). Approximately 60% of patients were premenopausal women. The two most common nongynecologic primary sites of ovarian metastasis were the colorectum (68 cases) and stomach (61 cases). In addition to the most common symptoms of abdominal distension (39.0%), abdominal pain (37.9%), and ascites (27.7%), 18.1% of patients presented with abnormal uterine bleeding. Half of the patients who tested serum CA-125 preoperatively had elevated CA-125 levels within the range of 35 U/ml to 200 U/ml. More than 70% of synchronous ovarian metastases were preoperatively misdiagnosed as primary ovarian cancer. Of all included cases, 56.5% achieved optimal cytoreductive surgery (the diameter of the largest residual lesion < 2 cm). The overall 5-year survival rate and median survival time were 10% and 20 months, respectively. The primary site, optimal cytoreductive surgery, tumor differentiation, and postoperative adjuvant treatment were identified as prognostic indicators. Conclusions The colorectum and stomach are the most common nongynecologic primary sites of ovarian metastasis. Synchronous ovarian metastasis is easily misdiagnosed as primary ovarian cancer. Optimal cytoreductive surgery and postoperative adjuvant treatment can be performed to confer survival benefit in selected patients.

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The Combination of Serum Biomarker (CA-125, FASN, and GLS) as a Predictor Suboptimal Cytoreduction in Epithelial Ovarian Cancer

10.21203/rs.2.21972/v1 ◽

2020 ◽

Author(s):

Gatot Nyarumenteng Adhipurnawan Winarno ◽

Yudi Mulyana Hidayat ◽

Setiawan Soetopo ◽

Sofie Rifayani Krisnadi ◽

Maringan Diapari Lumban Tobing ◽

...

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Cytoreductive Surgery ◽

Cross Sectional Study ◽

Ca 125 ◽

Cross Sectional ◽

Average Value ◽

Preoperative Serum ◽

Serum Ca125 ◽

Sensitivity Specificity

Abstract Purpose. Cytoreduction has an important role in improving the survival rate of epithelial ovarian cancer (EOC) patients. The use of preoperative CA-125 as an optimal predictor cytoreduction in patients with ovarian cancer is still controversial. This study aimed to assess the ability of preoperative serum CA125, FASN and GLS as a predictor of cytoreductive surgery in epithelial ovarian cancer (EOC). This observational-analytic cross-sectional study included 109 women diagnosed with epithelial ovarian cancer (EOC) between 2017-2019, who had serum CA-125, GLS, FASN measured preoperatively and underwent cytoreductive surgery. Result. The average value of serum CA-125, FASN, and GLS in the suboptimal cytoreduction were higher than the optimal cytoreduction group. The cut off point (COP) of CA-125 was 248.55 (p=0.0001) with 73.2% sensitivity and 73.6% specificity, FASN was 0.445 (p=0.017) with 62.5% sensitivity and 60.4% specificity, and GLS was 22.895 (p=0.0001) with 73.2% sensitivity and 75.5% specificity. The COP value of CA-125 and GLS combined was 29.16 (p=0.0001) with sensitivity 82.1% and spesificity 73.6%, while the COP of CA-125, GLS, and FASN combined was 0.83 (p=0.0001) with 87.5% sensitivity and 73.6% specificity. If the value of biomarker serum more than COP will more likely have suboptimal cytoreductive surgery. Conclusion. The role of CA125, FASN and GLS levels in predicting suboptimal cytoreductive surgery for patients with ovarian cancer seems questionable. However, the combination of CA-125 and GLS or CA-125, FASN and GLS are able to increase the sensitivity, specificity, and accuracy classification to predict suboptimal cytoreductive surgery.

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Clinical significance of preoperative serum CA-125 level in epithelial ovarian cancer

Korean Journal of Obstetrics & Gynecology ◽

10.5468/kjog.2012.55.2.69 ◽

2012 ◽

Vol 55 (2) ◽

pp. 69

Author(s):

Seung Ho Lee ◽

Hye Seung Yoo ◽

Jin Woo Shin ◽

Chan Yong Park

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Clinical Significance ◽

Ca 125 ◽

Preoperative Serum

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Predictive factors of cytoreductive surgery in epithelial ovarian cancer in a Mexican women cohort.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e17099 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e17099-e17099

Author(s):

Flavia Morales Vasquez ◽

Ricardo Raziel Peña Gonzalez ◽

Horacio Noé López Basave

Keyword(s):

Ovarian Cancer ◽

Cytoreductive Surgery ◽

Proportional Hazards ◽

Proportional Hazards Model ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Ca 125 ◽

Mexican Women ◽

Hazards Model ◽

Optimal Debulking

e17099 Background: Cytoreductive surgery is the most important prognostic factor in ovarian cancer. To identify in a timely manner the patients who are not candidates for optimal debulking, does not delay and optimize the treatment. Objetive: Identify the presurgical factors that characterize patients in whom optimal cytoreduction is not possible. Methods: Observational study in a retrospective cohort (n = 255) that compared pre-surgical factors between patients with optimal debulking (n = 65) and suboptimal (n = 190). Non-parametric tests were used, a Cox proportional hazards model was constructed and survival curves were drawn by method of Kaplan y Meier. Results: 255 patients were included. 75% achieved optimal debulking. 9 out of 10 evaluated tomography criteria showed association (p < 0.001) with suboptimal cytoreduction. The best cut-off value of Ca-125 to predict suboptimal surgery was 774 IU / mL. Only clinical ascites showed association with the result of the surgery (p < 0.001). There was no difference in complications between both groups (p = 0.267). The rate of optimal debulking has improved over time (p = 0.049). The turn of the surgeries has no impact on the overall survival of the patients (p = 0.792). Conclusions: Objective parameters (tomography and laboratory) should be used to select patients who are not candidates for surgery. The Clinical evaluation without objective parameters is not enough

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