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- Title
The prognostic and predictive value of CA-125 regression during neoadjuvant chemotherapy for advanced ovarian or primary peritoneal carcinoma.
- Authors
Vasudev, Naveen; Trigonis, Ioannis; Cairns, David; Hall, Geoff; Jackson, David; Broadhead, Timothy; Buxton, John; Hutson, Richard; Nugent, David; Perren, Timothy; Vasudev, Naveen S; Cairns, David A; Hall, Geoff D; Jackson, David P; Perren, Timothy J
- Abstract
<bold>Purpose: </bold>To assess the significance of CA-125 regression as a prognostic indicator and predictor of optimal cytoreduction at interval debulking surgery (IDS) in women with ovarian or primary peritoneal carcinoma receiving neoadjuvant chemotherapy (NAC).<bold>Methods: </bold>63 women treated between 2004 and 2007 with neoadjuvant platinum-based chemotherapy followed by IDS were studied retrospectively. Pre-operative CA-125 values were used to calculate a regression coefficient (CA-125r) using exponential regression analysis. Outcome endpoints were overall survival (OS), time to CA-125 progression (TTC) by Rustin criteria and time to second-line treatment (TTS).<bold>Results: </bold>Women with a CA-125 half-life greater than 18 days had a significantly worse OS compared to those with a half-life less than 12 days on univariate testing (HR 3.34, 95% CI 1.25-8.94, p = 0.017). On multivariable analysis, CA-125r was an independent predictor of OS [HR 1.18 (per 0.01 increase in CA-125r), 95% CI 1.01-1.40, p = 0.043]. CA-125r was independently predictive of TTC and TTS (HR 1.17, p ≈ 0.03 for each). CA-125r was also predictive of achieving optimal cytoreduction at IDS (AUC 0.756, p < 0.001).<bold>Conclusions: </bold>CA-125 regression rate during pre-operative NAC is of independent prognostic value. CA-125 regression rate strongly predicts for optimal cytoreduction.
- Subjects
CANCER chemotherapy; OVARIAN cancer; PERITONEAL cancer; CANCER prognosis; REGRESSION analysis; ADJUVANT treatment of cancer; ONCOLOGIC surgery; MEDICAL statistics; ANTINEOPLASTIC agents; CANCER diagnosis; CANCER; COMBINED modality therapy; COMPARATIVE studies; RESEARCH methodology; MEDICAL cooperation; MULTIVARIATE analysis; OVARIAN tumors; PROGNOSIS; RESEARCH; RESEARCH funding; TUMOR antigens; PERITONEUM tumors; EVALUATION research; PREDICTIVE tests; DISEASE remission; RETROSPECTIVE studies; KAPLAN-Meier estimator
- Publication
Archives of Gynecology & Obstetrics, 2011, Vol 284, Issue 1, p221
- ISSN
0932-0067
- Publication type
journal article
- DOI
10.1007/s00404-010-1655-2