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Annals of Oncology Advance Access published online on June 9, 2006
Annals of Oncology, doi:10.1093/annonc/mdl120
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© 2006 European Society for Medical Oncology
Received July 13, 2005
Revised March 22, 2006
Accepted April 13, 2006

original article

CA 125 half-life and CA 125 nadir during induction chemotherapy are independent predictors of epithelial ovarian cancer outcome: results of a French multicentric study

J. M. Riedinger 1 *, J. Wafflart 2, G. Ricolleau 3, N. Eche 4, H. Larbre 5, J. P. Basuyau 6, I. Dalifard 7, K. Hacene 8, and M. F. Pichon 9

1 Laboratoire de Biologie Médicale, Centre GF. Leclerc, Dijon, France
2 Laboratoire de Radioanalyse, Institut Bergonié, Bordeaux, France
3 Laboratoire d' Oncobiologie, Centre René Gauducheau, Nantes, France
4 Laboratoire de Biologie, Institut Claudius Regaud, Toulouse, France
5 Laboratoire de Biologie Clinique, Institut J Godinot, Reims, France
6 Laboratoire de Biologie, Centre H Becquerel, Rouen, France
7 Laboratoire de Radioanalyse, Centre P. Papin, Angers, France
8 Service de Statistiques Médicales, Centre René Huguenin, Saint-Cloud, France
9 Laboratoire d'Oncobiologie, Centre René Huguenin, Saint-Cloud, France

* To whom correspondence should be addressed.
J. M. Riedinger, E-mail: jriedinger{at}dijon.fnclcc.fr


  Abstract

Background: CA 125 assays enable treatment-response monitoring in ovarian cancer.

Patients and methods: A multicentric study of CA 125 kinetics under induction chemotherapy was performed in 631 patients. CA 125 half-life was calculated by mono-compartmental logarithmic regression. Nadir CA 125 concentration and time to nadir were also studied. Survival analyses for disease-free survival (DFS) and overall survival (OS) used univariate (Kaplan-Meier) and multivariate (Cox) models.

Results: For 553 stage IIC-IV patients, 459 (83.0%) relapsed and 444 (80.3%) died from cancer. Median (range) follow up time was 32 months (2-214 months). Median (range) for CA 125 kinetics were: 263 kU/l (5-52000 kU/l) before 1st course, 15.8 days (4.5-417.9 days) for CA 125 half-life, 16 kU/l (3-2610 kU/l) for nadir and 85 days (0-361 days) for time to nadir. Pre-chemotherapy CA 125, its half-life, nadir concentration and time to nadir all had a univariate prognostic value for DFS and OS (P < 0.0001). In Cox models, CA 125 half-life, residual tumour (P < 0.0001 for both), nadir concentration (P = 0.0002) and stage (P = 0.0118) were the most powerful prognostic factors for DFS. For OS, the significant variables were similar, with age ranking last (P = 0.0319).

Conclusion: Among well-established prognostic factors in ovarian cancers, CA 125 half-life and nadir concentration bear a strong and independent prognostic value.

Keywords: CA 125; ovarian cancer; survival.
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