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CA 125 dynamics during lifetime as prognostic factor for ovarian cancer (OC) patients

Domenii publicaţii > Ştiinţe medicale + Tipuri publicaţii > Articol în volumul unei conferinţe

Autori: Banu E, Oudard S, Levy E, Fabre-Guillevin E, Banu A, Ayllon J, Scotte F, Fodor A, Andrieu JM

Editorial: Educational and Abstract Book 2005;16, supplement 2, ii296, Abstract 94O. Poster and oral presentation. ESMO Scientific and Educational Conference, June 2-5, Budapest., 2005.


Background: Predicting outcome for women with OC remains imprecise and further evaluation of accepted and potential predictive factors is needed. Treatment strategies according to CA 125 levels during natural history of ovarian disease are strategic and must be clearly identified.
Methods: The CA 125 dynamics during lifetime (CA 125 “exposure”) was estimated by corrected area under CA 125 curve (CA 125 c-AUC). C-AUC was already tested for other tumor markers as prostate-specific antigen (PSA c-AUC, abstr 9579, ASCO 2004). Based on their CA 125 c-AUC values (< 120 vs > 120 UI/mL), patients (pts) were analyzed according to time from primary diagnosis (TPD) as major survival endpoint. TPD was calculated from primary diagnosis until death or last follow-up. A prognostic scoring system was created using the Kaplan-Meier method to classify pts according to risk of death.
Results: One hundred and two OC pts treated in a single institution between 1982 and 2004 entered onto this analysis. Median age at initial diagnosis was 59 years (range 31-88). The CA 125 observation time ranged between 0.1 and 8 years, with a median of 1.4 years. Median number of CA 125 determinations was 11 (range 2-50). Univariate analysis by Cox proportional hazard model showed that age and FIGO stage at initial diagnosis were associated with TPD probabilities. Age was identified as only significant factor for TPD by multivariate analysis (P=0.04). There were significant TPD differences (P = 0.03) according to risk of death, stratified by age. Only 27% of older pts (>60 years) with high marker levels during lifetime (CA 125 c-AUC > 120 UI/mL) are alive at 5 years, with a median TPD of 3.3 years (95% CI 1.3-5.4 years). The TPD percentage was three times lower compared with the low risk group [(age <60 years and CA 125 c-AUC <120 UI/mL), 80% vs 27%, respectively]. All stage IV pts at initial diagnosis with low CA 125 exposure are alive at 2 years, comparing with 38% of pts with high CA 125 exposure, independently of age. Conclusions: It is reasonable to state that pts whose CA-125 values are higher during lifetime (CA 125 c-AUC >120 UI/mL) have a higher risk of death. Consequently, these pts are candidates for early aggressive treatments in phase II-III clinical trials. Such a management strategy has been considered utilizing the PSA dynamics in metastatic hormone-refractory prostate cancer.

Cuvinte cheie: cancer ovarian, CA 125 aria sub curba, supravietuire // ovarian cancer, CA 125 area under the curve, survival