Abstract
BACKGROUND: There are limited data regarding unique clinical or laboratory features associated with advanced clear cell (CC) and mucinous (MU) epithelial ovarian cancers (EOC), particularly the relationship between CA-125 antigen levels and prognosis. METHODS: A retrospective review of 7 previously reported Gynecologic Oncology Group phase 3 trials in patients with stage III/IV EOC was conducted. A variety of clinical parameters were examined, including the impact of baseline and changes in the CA-125 level after treatment of CC and MU EOC on progression-free (PFS) and overall survival (OS). RESULTS: Clinical outcomes among patients with advanced CC and MU EOC were significantly worse when compared with other cell types (median PFS, 9.7 vs 7.0 vs 16.7 months, respectively, P <.001; median OS, 19.4 vs 11.3 vs 40.5 months, respectively, P <.001). Suboptimal debulking was associated with significantly decreased PFS and OS among both. Although baseline CA-125 values were lower in CC (median, 154 μ/mL) and MU (100 μ/ mL), compared with other cell types (275 μ/mL), this level did not appear to influence outcome among these 2 specific subtypes of EOC. However, an elevated level of CA-125 at the end of chemotherapy was significantly associated with decreased PFS and OS (P <.01 for all). CONCLUSIONS: Surgical debulking status is the most important variable at prechemotherapy predictive of prognosis among advanced CC and MU EOC patients. Changes in the CA-125 levels at the end treatment as compared with baseline can serve as valid indicators of PFS and OS, and likely the degree of inherent chemosensitivity.
Original language | English (US) |
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Pages (from-to) | 1395-1403 |
Number of pages | 9 |
Journal | Cancer |
Volume | 115 |
Issue number | 7 |
DOIs | |
State | Published - Apr 1 2009 |
Externally published | Yes |
Keywords
- CA-125
- Clear cell cancer
- Mucinous cell cancer
- Ovarian cancer
ASJC Scopus subject areas
- Oncology
- Cancer Research