CA-125 Levels Are Predictive of Survival in Low-Grade Serous Ovarian Cancer—A Multicenter Analysis

Abstract

Objective: Studies on low-grade serous ovarian cancer (LGSC) are limited by a low number of cases. The aim of this study was to define the prognostic significance of age, stage, and CA-125 levels on survival in a multi-institutional cohort of women with pathologically confirmed LGSC. Methods: Women with LGSC were identified from the collaborative Ovarian Cancer Association Consortium (OCAC). Cases of newly diagnosed primary LGSC were included if peri-operative CA-125 levels were available. Age at diagnosis, FIGO stage, pre- and post-treatment CA-125 levels, residual disease, adjuvant chemotherapy, disease recurrence, and vital status were collected by the participating institutions. Progression-free (PFS) and overall survival (OS) were calculated. Multivariable (MVA) Cox proportional hazard models were used and hazard ratios (HR) calculated. Results: A total of 176 women with LGSC were included in this study; 82% had stage III/IV disease. The median PFS was 2.3 years and the median OS was 6.4 years. Age at diagnosis was not significantly associated with worse PFS (p = 0.23) or OS (p = 0.3) (HR per year: 0.99; 95%CI, 0.96–1.01 and 0.98; 95%CI 0.95–1.01). FIGO stage III/IV was independently associated with PFS (HR 4.26, 95%CI 1.43–12.73) and OS (HR 1.69, 95%CI 0.56–5.05). Elevated CA-125 (≥35 U/mL) at diagnosis was not significantly associated with worse PFS (p = 0.87) or OS (p = 0.78) in MVA. Elevated CA-125 (≥35 U/mL) after completion of primary treatment was independently associated with worse PFS (HR 2.81, 95%CI 1.36–5.81) and OS (HR 6.62, 95%CI 2.45–17.92). In the MVA, residual disease was independently associated with PFS (0.022), but not OS (0.85). Conclusion: Advanced LGSC was associated with poor long-term prognosis. FIGO stage and abnormal post-treatment CA-125 level are key prognostic factors inversely associated with PFS and OS. Highlights: 1. Through a multi-center collaborative effort, data from 176 women with low-grade serous ovarian cancer were analyzed. 2. Although low-grade serous ovarian cancer is often considered indolent, the progression-free and overall survival are poor. 3. Elevated post-treatment CA-125 levels are independently associated with poor survival.

Role of Selected Circulating Tumor Biomarkers in Patients with Skeletal Metastatic Pancreatic Neuroendocrine Neoplasms

“…It has limited sensitivity in detecting ovarian cancer, but it helps monitor response to treatment and detect residual or recurrent disease after therapy. Its level also correlates with staging and tumor size [39][40][41]. Zhang M. et al proved that CA125 is significantly elevated not only in ovarian cancer but also in lung and pancreatic cancer and decreased in rectal cancer [42].…”

A retrospective, real-life analysis of metronomic oral single-agent cyclophosphamide for the treatment of platinum-pretreated advanced ovarian carcinoma in Italy

“…Low-grade indolent tumors are a subgroup of ovarian cancer with less aggressive behavior and a better prognosis, whose biomolecular characterization is in progress. [25][26][27] Other subgroups of patients potentially amenable to MOC may require aggressive intravenous chemotherapy-free intervals for toxicity-, performance status-or emotion-related issues. 28,29 MOC may represent, as well as other regimens and schedules, a possible cure for people living in low-and middle-income countries.…”

Đánh Giá Kết Quả Điều Trị Ung Thư Biểu Mô Buồng Trứng Thể Thanh Dịch Độ Thấp Tại Bệnh Viện K

“…Theo nghiên tác giả Christoph Wohlmuth và cộng sự, 86% BN UTBMBT thanh dịch độ thấp có CA 12-5 tăng cao. 6 Các dữ liệu cho thấy đa phần UTBMBT thanh dịch độ thấp có chỉ số CA 12-5 tăng cao. Do đó, CA 12-5 là chất chỉ điểm u tốt trong chẩn đoán và theo dõi tình trạng bệnh trong quá trình điều trị.…”

“…Theo tác giả Christoph Wohlmuth và cộng sự, 82% BN được chẩn đoán ở giai đoạn III,IV. 6 Nghiên cứu của chúng tôi có tỷ lệ thấp hơn các BN được chẩn đoán ở giai đoạn muộn, có thể do có sự khác biệt về mẫu nghiên cứu.…”