Serum CA 125 levels and survival in advanced ovarian cancer

Münstedt, Karsten; Krisch, M.; Sachsse, S.; Vahrson, H

doi:10.1007/bf02505319

Cited by 14 publications

(8 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Rustin et al [10] reported that CA125 can give prognostic information based on serial CA125 levels to measure the response of ovarian carcinoma in patients receiving first-line chemotherapy. In the present study, we demonstrated that absolute CA125 serum levels were a poor guide to prognosis, in accordance with other studies [11,12]. In addition, STN has been shown to be independently associated with prognosis and a strong prediction of survival [13].…”

Section: Discussionsupporting

confidence: 92%

Preoperative Determination of Several Serum Tumor Markers in Patients with Primary Epithelial Ovarian Carcinoma

Kudoh

Kikuchi

Kita

et al. 1999

Gynecol Obstet Invest

View full text Add to dashboard Cite

This study was designed to evaluate the clinical significance of the use of preoperative serum tumor markers in primary epithelial ovarian cancer. Subjects comprised 111 patients with primary epithelial ovarian cancer. Lactate dehydrogenase (LDH), α-hydroxybutyrate dehydrogenase (HBDH), carcinoembryonic antigen (CEA), CA19-9, tissue polypeptide antigen (TPA), CA125 and sialyl TN (STN) serum levels were measured within 7 days before surgery. The tumor marker values were compared with the histopathologic diagnosis. The overall agreement between the test results and the actual outcome was calculated using Student’s t test and analysis of variance (ANOVA). Survival curves were constructed according to the Kaplan-Meier method, and differences in survival were assessed with the log-rank test. The prognostic significance of tumor markers for survival was assessed in a multivariate analysis with the Cox proportional hazards model. Of the tumor markers examined in this study, CA125 showed the highest positive rate (77.6%), followed by 63.2% for STN and 55.9% for CA19-9. When the positive rate was compared according to histologic types, serous cystadenocarcinoma, mucinous cystadenocarcinoma, endometrioid adenocarcinoma and clear cell carcinoma showed the highest positive rates for CA125 (94.1%), CA19-9 (76.9%), CA125 (91.7%) and STN (75.0%), respectively. Regarding the distribution of tumor marker levels according to the FIGO stage, LDH, HBDH, TPA and CA125 were correlated with the clinical stage while CEA, CA19-9 and STN did not show any correlation. From analyses of tumor marker levels according to histologic types, all patients with a ratio of CA125 to CEA of >1,000 had serous cystadenocarcinoma and a ratio of CA125 to CA19-9 of >50 showed serous cystadenocarcinoma or endometrioid adenocarcinoma. On the other hand, all patients with a ratio of LDH or HBDH to CA19-9 of <1.0 had mucinous cystadenocarcinoma or clear cell carcinoma. From univariate analysis, the survival time of patients with elevated CA125, TPA or STN was significantly shorter than that of patients with normal CA125, TPA or STN levels. When the Cox’s proportional hazard model was used, we identified age, clinical stage, clear cell carcinoma and serum STN as independent prognostic factors. Serum CA125, TPA or STN may give significant prognostic information in epithelial ovarian carcinoma. It is noteworthy that STN has been identified as an independent prognostic factor and has a high rate of positivity in clear cell carcinoma.

show abstract

Section: Discussionsupporting

confidence: 92%

Preoperative Determination of Several Serum Tumor Markers in Patients with Primary Epithelial Ovarian Carcinoma

Kudoh

Kikuchi

Kita

et al. 1999

Gynecol Obstet Invest

View full text Add to dashboard Cite

show abstract

“…3 Several authors have explored the clinical significance of serum CA-125 changes during the early postoperative period, but there is still no agreement regarding the prognostic value of post-operative CA-125. [4][5][6] The clinical significance of serum CA-125 decline immediately after primary cytoreductive surgery is uncertain. Furthermore, the relationship between postoperative declines of serum CA-125 and survival has not been clearly defined yet.…”

Section: Introductionmentioning

confidence: 99%

Significance of postoperative CA-125 decline after cytoreductive surgery in stage IIIC/IV ovarian cancer

et al. 2008

View full text Add to dashboard Cite

Objective: The purpose of this study was to evaluate whether the decline in serum CA-125 levels following primary cytoreductive surgery prior to starting adjuvant chemotherapy has a prognostic value in patients with stage IIIC/IV ovarian carcinoma. Methods: A retrospective review was conducted of all patients with stage IIIC/IV ovarian carcinoma who underwent primary cytoreductive surgery followed by platinum-based chemotherapy from 1994 to 2007. Demographic, pathologic, treatment, and survival data were collected. Patients were included if serum CA-125 levels were drawn preoperatively and within one week prior to their first chemotherapy cycle, and whose postoperative CA-125 level declined. Percentage decline was calculated, and was compared with standard statistical tests in groups by 25% declination intervals. Results: Of the 112 stage IIIC/IV patients, 81 (72.3%) met the above inclusion criteria. The median time from surgery to postoperative CA-125 sampling was 16 days (range: 7-42). A ≥75% decline was associated with a median progression-free survival (PFS) of 25 months (95% CI=0-63). This was significantly longer when compared with each of the other 25% interval groups. After multivariate analysis, independent prognostic factors included a ≥75% decline in CA-125 levels after surgery and the presence of residual tumor. Age, grade, histology, and preoperative CA-125 levels were not statistically significant factors. Conclusion: A ≥75% decline in serum CA-125 serum levels from primary cytoreductive surgery to the start of adjuvant chemotherapy has independent prognostic value for PFS in patients with stage IIIC/IV ovarian carcinoma.

show abstract

“…However, when the class membership is certain, the parameter estimation does not lead to loss of efficiency ([31]). Although we only used biomarker trajectory data in the first stage to estimate the latent class membership, the misclassification rate should be low since the trajectory describes biomarker behavior and significantly correlated with survival ([48], [49], [50], [51], [52], [53]) and the biomarker trajectory pattern has been viewed as a latent class, and moreover we used MI to account for the uncertainty of latent class membership which helps minimize loss of efficiency. Specifically in our example the estimated misclassification rate, presented in Section 4.2, is low.…”

Section: Discussionmentioning

confidence: 99%

Dynamic optimal strategy for monitoring disease recurrence

Gatsonis

2012

Sci. China Math.

View full text Add to dashboard Cite

Surveillance to detect cancer recurrence is an important part of care for cancer survivors. In this paper we discuss the design of optimal strategies for early detection of disease recurrence based on each patient's distinct biomarker trajectory and periodically updated risk estimated in the setting of a prospective cohort study. We adopt a latent class joint model which considers a longitudinal biomarker process and an event process jointly, to address heterogeneity of patients and disease, to discover distinct biomarker trajectory patterns, to classify patients into different risk groups, and to predict the risk of disease recurrence. The model is used to develop a monitoring strategy that dynamically modifies the monitoring intervals according to patients' current risk derived from periodically updated biomarker measurements and other indicators of disease spread. The optimal biomarker assessment time is derived using a utility function. We develop an algorithm to apply the proposed strategy to monitoring of new patients after initial treatment. We illustrate the models and the derivation of the optimal strategy using simulated data from monitoring prostate cancer recurrence over a 5-year period.

show abstract

Serum CA 125 levels and survival in advanced ovarian cancer

Cited by 14 publications

References 23 publications

Preoperative Determination of Several Serum Tumor Markers in Patients with Primary Epithelial Ovarian Carcinoma

Preoperative Determination of Several Serum Tumor Markers in Patients with Primary Epithelial Ovarian Carcinoma

Significance of postoperative CA-125 decline after cytoreductive surgery in stage IIIC/IV ovarian cancer

Dynamic optimal strategy for monitoring disease recurrence

Contact Info

Product

Resources

About