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Archives of Gynecology and Obstetrics
Published in: Archives of Gynecology and Obstetrics 1/2011

01-07-2011 | Gynecologic Oncology

The prognostic and predictive value of CA-125 regression during neoadjuvant chemotherapy for advanced ovarian or primary peritoneal carcinoma

Authors: Naveen S. Vasudev, Ioannis Trigonis, David A. Cairns, Geoff D. Hall, David P. Jackson, Timothy Broadhead, John Buxton, Richard Hutson, David Nugent, Timothy J. Perren

Published in: Archives of Gynecology and Obstetrics | Issue 1/2011

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Abstract

Purpose

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).

Methods

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).

Results

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).

Conclusions

CA-125 regression rate during pre-operative NAC is of independent prognostic value. CA-125 regression rate strongly predicts for optimal cytoreduction.
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Metadata
Title
The prognostic and predictive value of CA-125 regression during neoadjuvant chemotherapy for advanced ovarian or primary peritoneal carcinoma
Authors
Naveen S. Vasudev
Ioannis Trigonis
David A. Cairns
Geoff D. Hall
David P. Jackson
Timothy Broadhead
John Buxton
Richard Hutson
David Nugent
Timothy J. Perren
Publication date
01-07-2011
Publisher
Springer-Verlag
Published in
Archives of Gynecology and Obstetrics / Issue 1/2011
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-010-1655-2

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