Defining progression of ovarian carcinoma during follow-up according to CA 125: A North Thames Ovary Group study

Rustin, G. J. S.; Nelstrop, Ann E.; Tuxen, M. K.; Lambert, H. E.

doi:10.1093/oxfordjournals.annonc.a010602

Cited by 259 publications

(155 citation statements)

References 6 publications

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“…[8][9][10] And the sensitivity and specificity of PET-CT are 93.3-97.4% and 80-100%, respectively. [11,12] A recent meta-analysis of 29 studies demonstrated that PET-CT had high sensitivity (89%) and specificity (90%).…”

Section: Discussionmentioning

confidence: 99%

Impact of FDG PET in optimizing patient selection for cytoreductive surgery in recurrent ovarian cancer

Ebina

Watari

Kaneuchi

et al. 2013

Eur J Nucl Med Mol Imaging

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Purpose. To investigate the impact of PET and PET-CT scanning on decision-making in the management plans and to identify the optimal setting for selecting candidate for surgery in suspicious recurrent ovarian cancer. Results. After PET scanning, the management plan was changed on 52 of 89 occasions (58.4%). The total number of cytoreductive surgeries selected as a treatment choice increased from 12 to 35. Miliary disseminated disease, which was not detected by PET scan, was found in 22.2% of surgeries. Miliary disseminated disease was detected in 6 of the 12 recurrent cases whose treatment-free interval (TFI) <12 months, whereas none of those with a TFI ≥12 months had such disease (p=0.0031). MethodsConclusions. PET or PET-CT is useful for selecting cytoreductive surgery candidates among patients with recurrent ovarian cancer. To avoid surgical attempts at miliary dissemination, patients with TFI ≥12 months are the best cytoreducive surgery candidates.

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Section: Discussionmentioning

confidence: 99%

Impact of FDG PET in optimizing patient selection for cytoreductive surgery in recurrent ovarian cancer

Ebina

Watari

Kaneuchi

et al. 2013

Eur J Nucl Med Mol Imaging

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“…Time to progression (disease-free survival) was defined as the interval from the date of treatment initiation until the disease progression was clinically evidenced by a 25% or greater increase in tumor size, appearance of new lesions, or a rise of serum CA 125 level to more than twice the upper limit of normal. 31,32 Mean time to progression was calculated as the average time from diagnosis until the date of relapse. To analyze response to primary therapy, we grouped patients as responders or non-responders to the primary therapy.…”

Section: Patient Selectionmentioning

confidence: 99%

Low membranous expression of β-catenin and high mitotic count predict poor prognosis in endometrioid carcinoma of the ovary

et al. 2010

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Mutations in the b-catenin gene are common in ovarian endometrioid carcinoma. Few studies have addressed the association of b-catenin expression with tumor characteristics and patient outcome, yielding controversial results. The purpose of this study was to retrospectively assess the expression of b-catenin in ovarian endometrioid carcinoma and correlate its expression with the Gynecologic Oncology Group's (GOG) grading system, clinicopathological characteristics, and patient survival. A total of 49 patients with primary ovarian endometrioid carcinoma were included in this study. A four-tier score grading system was used for the membranous staining (negative, weak, moderate, and strong) and the percentage of positive cells for the nuclear staining of b-catenin. The status of five morphometric parameters, nuclear morphology (uniform or pleomorphic), mitotic count, glandular pattern, degree of squamous differentiation, and status of papillary pattern, was assessed. We found that a low membranous expression of b-catenin and a high mitotic count (415 per 10 high-power fields) were significantly associated with poor prognosis and early recurrence of ovarian endometrioid carcinoma. In addition, cases with nuclear expression of b-catenin showed an intermediate overall survival risk and late disease recurrence. Young age at the time of diagnosis, advanced disease stage, and suboptimal debulking were among the clinical factors predicting poor survival and early disease recurrence. The presence of squamous differentiation, a papillary pattern or nuclear pleomorphism did not show any correlation with overall survival or disease-free survival. Low membranous expression of b-catenin and high mitotic count are poor prognostic indicators in patients with ovarian endometrioid carcinoma, whereas the GOG grading system showed no prognostic value. Our data suggest that there is a need to define a better grading system for ovarian endometrioid carcinoma. Molecular markers such as b-catenin and mitotic count could aid in defining this grading system.

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“…The previously validated CA125 progression criteria (Rustin et al, 1996b(Rustin et al, , 2001Vergote et al, 2000) is defined as either a doubling of the CA 125 levels from the nadir value achieved during previous therapy or a doubling from the upper limit of normal. (Value defined at local laboratories.)…”

Section: Response Assessmentmentioning

confidence: 99%

A phase II study of sequential carboplatin, paclitaxel and topotecan in patients with previously untreated advanced ovarian cancer

et al. 2004

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We evaluated the sequential use of carboplatin, paclitaxel and topotecan in patients with advanced, previously untreated ovarian cancer. In total, 43 patients with advanced ovarian cancer and 41 cm residual disease were treated with sequential carboplatin (areaunder-the-curve (AUC) 5 days 1 and 22), paclitaxel (175 mg m À2 days 43 and 64) and topotecan (1.5 mg m À2 daily for 5 days from days 85, 106, 127 and 148). Median age of patients was 61 years. Median follow-up was 22.2 months (range 0.76 -50.6 months). In all, 34 (79%) patients received all eight cycles of treatment and nine (21%) withdrew. Of the 29 evaluable patients, 19 (66%) responded according to WHO and 30 of 36 (83%) patients according to CA125. The best overall response (CA125 and/or WHO) was 77% (33 of 43 patients). The response rates to sequential drugs based on 450% fall in CA125 were as follows: carboplatin, 77% (30 of 39 patients); paclitaxel, 65% (15 of 23 patients); topotecan, 38% (five of 13 patients). Two patients responded to paclitaxel and one to topotecan after failure to respond to preceding chemotherapy. Median survival and time to progression was 22.24 and 10.61 months, respectively. This study demonstrates that sequential chemotherapy with just two initial courses of carboplatin is a reasonable way to introduce new agents into first-line therapy for poor prognostic ovarian cancer patients.

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Defining progression of ovarian carcinoma during follow-up according to CA 125: A North Thames Ovary Group study

Abstract: A confirmed rise of serum CA 125 level to more than twice the upper limit of normal during follow up after first line chemotherapy accurately predicts tumour relapse.

Cited by 259 publications

References 6 publications

Impact of FDG PET in optimizing patient selection for cytoreductive surgery in recurrent ovarian cancer

Impact of FDG PET in optimizing patient selection for cytoreductive surgery in recurrent ovarian cancer

Low membranous expression of β-catenin and high mitotic count predict poor prognosis in endometrioid carcinoma of the ovary

A phase II study of sequential carboplatin, paclitaxel and topotecan in patients with previously untreated advanced ovarian cancer

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