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Annals of Oncology Advance Access originally published online on December 6, 2007
Annals of Oncology 2008 19(2):327-331; doi:10.1093/annonc/mdm495
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© 2007 European Society for Medical Oncology. For Permissions, please email: journals.permissions@oxfordjournals.org

gynecologic tumors

Nadir CA-125 concentration in the normal range as an independent prognostic factor for optimally treated advanced epithelial ovarian cancer

A. Prat1,*, M. Parera1, S. Peralta1, M. A. Perez-Benavente2, A. Garcia3, A. Gil-Moreno2, J. M. Martinez-Palones2, I. Roxana1, J. Baselga1 and J. M. Del Campo1

1 Department of Medical Oncology
2 Department of Gynecologic Oncology
3 Department of Pathology, Vall d'Hebron University Hospital, Barcelona, Spain

* Correspondence to: Dr A. Prat, Department of Medical Oncology, Vall d'Hebron University Hospital, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain. Tel: +34-93-489-30-00; Fax:+34-93-274-60-59; E-mail: alprat{at}vhebron.net

Background: The amount of residual disease after surgery is considered the most important factor influencing the survival of patients with advanced epithelial ovarian cancer (adEOC). In optimally treated patients with adEOC, there are no well-established prognostic factors [excluding International Federation of Gynecology and Obstetrics (FIGO) stage]. The aim of this retrospective study is to analyze the prognostic value of the CA-125 nadir after the completion of an optimal primary treatment.

Patients and methods: Patients treated for adEOC were identified from January 1998 to December 2006. Inclusion criteria: elevated CA-125 at time of diagnosis (>35 kU/l); FIGO stage III–IV treated with optimal primary treatment (residual tumor <1 cm and carboplatin/taxane-based combination chemotherapy); and complete response to optimal primary treatment with normalization of CA-125.

Results: Patients, n = 96: 44 group A (≤10 kU/l); 52 group B (11–35 kU/l). Median progression-free survival (PFS) was 42 and 20 months for groups A and B, respectively (P = 0.0087). Median overall survival (OS) was 84 and 43 months for groups A and B, respectively (P < 0.0001). The Cox model showed a highly significant impact on PFS and OS in relation to CA-125 nadir levels.

Conclusions: The CA-125 nadir value is a strong independent prognostic factor for optimally treated adEOC after achieving a complete response.

Key words: CA-125 nadir, carboplatin, ovarian cancer, paclitaxel, prognostic factor

Received for publication June 9, 2007. Revision received August 14, 2007. Accepted for publication September 14, 2007.


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A. Prat, M. Parera, and J. M. Del Campo
Prognostic Role of CA-125 Nadir in Stage IV Epithelial Ovarian Cancer
J. Clin. Oncol., April 1, 2008; 26(10): 1771 - 1772.
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