Risk of epithelial ovarian cancer recurrence in patients with rising serum CA-125 levels within the normal range

Antonio Santillan-Gomez, Ruchi Garg, Marianna L. Zahurak, Ginger J. Gardner, Robert L. Giuntoli, Deborah Kay Armstrong, Robert E. Bristow

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate the risk of epithelial ovarian cancer (EOC) recurrence in patients with rising serum cancer antigen 125 (CA-125) levels that remain below the upper limit of normal (<35 U/mL). Patients and Methods: All patients treated for EOC between September 1997 and March 2003 were identified and screened retrospectively for the following: (1) elevated serum CA-125 at time of diagnosis, (2) complete clinical and radiographic response (CR) to initial treatment with normalization of serum CA-125, (3) at least three serial serum CA-125 determinations that remained within the normal range, and (4) clinical and/or radiographic determination of disease status at the time of last follow-up or recurrence. For statistical analyses, univariate regression models were used to compare absolute and relative changes in CA-125 levels among patients with recurrent disease and those without EOC recurrence. Results: A total of 39 patients satisfied study inclusion criteria; 22 patients manifested EOC recurrence at a median interval from complete response of 11 months. The median follow-up time from complete response to last contact was 32 months for the 17 patients in the no recurrence group. A relative increase in CA-125 of 100% (odds ratio [OR] = 23.7; 95% CI, 2.9 to 192.5; P = .003) was significantly predictive of recurrence. From baseline CA-125 nadir levels, an absolute increase in CA-125 of 5 U/mL (OR = 8.4; 95% CI, 2.2 to 32.6; P = .002) and 10 U/mL (OR = 71.2; 95% CI, 4.8 to > 999.9; P = .002) were also significantly associated with the likelihood of concurrent disease recurrence. Conclusion: Among patients with EOC in complete clinical remission, a progressive low-level increase in serum CA-125 levels is strongly predictive of disease recurrence.

Original languageEnglish (US)
Pages (from-to)9338-9343
Number of pages6
JournalJournal of Clinical Oncology
Volume23
Issue number36
DOIs
StatePublished - 2005

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Reference Values
Antigens
Recurrence
Serum
Neoplasms
Ovarian epithelial cancer

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Risk of epithelial ovarian cancer recurrence in patients with rising serum CA-125 levels within the normal range. / Santillan-Gomez, Antonio; Garg, Ruchi; Zahurak, Marianna L.; Gardner, Ginger J.; Giuntoli, Robert L.; Armstrong, Deborah Kay; Bristow, Robert E.

In: Journal of Clinical Oncology, Vol. 23, No. 36, 2005, p. 9338-9343.

Research output: Contribution to journalArticle

Santillan-Gomez, Antonio ; Garg, Ruchi ; Zahurak, Marianna L. ; Gardner, Ginger J. ; Giuntoli, Robert L. ; Armstrong, Deborah Kay ; Bristow, Robert E. / Risk of epithelial ovarian cancer recurrence in patients with rising serum CA-125 levels within the normal range. In: Journal of Clinical Oncology. 2005 ; Vol. 23, No. 36. pp. 9338-9343.
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title = "Risk of epithelial ovarian cancer recurrence in patients with rising serum CA-125 levels within the normal range",
abstract = "Purpose: To evaluate the risk of epithelial ovarian cancer (EOC) recurrence in patients with rising serum cancer antigen 125 (CA-125) levels that remain below the upper limit of normal (<35 U/mL). Patients and Methods: All patients treated for EOC between September 1997 and March 2003 were identified and screened retrospectively for the following: (1) elevated serum CA-125 at time of diagnosis, (2) complete clinical and radiographic response (CR) to initial treatment with normalization of serum CA-125, (3) at least three serial serum CA-125 determinations that remained within the normal range, and (4) clinical and/or radiographic determination of disease status at the time of last follow-up or recurrence. For statistical analyses, univariate regression models were used to compare absolute and relative changes in CA-125 levels among patients with recurrent disease and those without EOC recurrence. Results: A total of 39 patients satisfied study inclusion criteria; 22 patients manifested EOC recurrence at a median interval from complete response of 11 months. The median follow-up time from complete response to last contact was 32 months for the 17 patients in the no recurrence group. A relative increase in CA-125 of 100{\%} (odds ratio [OR] = 23.7; 95{\%} CI, 2.9 to 192.5; P = .003) was significantly predictive of recurrence. From baseline CA-125 nadir levels, an absolute increase in CA-125 of 5 U/mL (OR = 8.4; 95{\%} CI, 2.2 to 32.6; P = .002) and 10 U/mL (OR = 71.2; 95{\%} CI, 4.8 to > 999.9; P = .002) were also significantly associated with the likelihood of concurrent disease recurrence. Conclusion: Among patients with EOC in complete clinical remission, a progressive low-level increase in serum CA-125 levels is strongly predictive of disease recurrence.",
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T1 - Risk of epithelial ovarian cancer recurrence in patients with rising serum CA-125 levels within the normal range

AU - Santillan-Gomez, Antonio

AU - Garg, Ruchi

AU - Zahurak, Marianna L.

AU - Gardner, Ginger J.

AU - Giuntoli, Robert L.

AU - Armstrong, Deborah Kay

AU - Bristow, Robert E.

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N2 - Purpose: To evaluate the risk of epithelial ovarian cancer (EOC) recurrence in patients with rising serum cancer antigen 125 (CA-125) levels that remain below the upper limit of normal (<35 U/mL). Patients and Methods: All patients treated for EOC between September 1997 and March 2003 were identified and screened retrospectively for the following: (1) elevated serum CA-125 at time of diagnosis, (2) complete clinical and radiographic response (CR) to initial treatment with normalization of serum CA-125, (3) at least three serial serum CA-125 determinations that remained within the normal range, and (4) clinical and/or radiographic determination of disease status at the time of last follow-up or recurrence. For statistical analyses, univariate regression models were used to compare absolute and relative changes in CA-125 levels among patients with recurrent disease and those without EOC recurrence. Results: A total of 39 patients satisfied study inclusion criteria; 22 patients manifested EOC recurrence at a median interval from complete response of 11 months. The median follow-up time from complete response to last contact was 32 months for the 17 patients in the no recurrence group. A relative increase in CA-125 of 100% (odds ratio [OR] = 23.7; 95% CI, 2.9 to 192.5; P = .003) was significantly predictive of recurrence. From baseline CA-125 nadir levels, an absolute increase in CA-125 of 5 U/mL (OR = 8.4; 95% CI, 2.2 to 32.6; P = .002) and 10 U/mL (OR = 71.2; 95% CI, 4.8 to > 999.9; P = .002) were also significantly associated with the likelihood of concurrent disease recurrence. Conclusion: Among patients with EOC in complete clinical remission, a progressive low-level increase in serum CA-125 levels is strongly predictive of disease recurrence.

AB - Purpose: To evaluate the risk of epithelial ovarian cancer (EOC) recurrence in patients with rising serum cancer antigen 125 (CA-125) levels that remain below the upper limit of normal (<35 U/mL). Patients and Methods: All patients treated for EOC between September 1997 and March 2003 were identified and screened retrospectively for the following: (1) elevated serum CA-125 at time of diagnosis, (2) complete clinical and radiographic response (CR) to initial treatment with normalization of serum CA-125, (3) at least three serial serum CA-125 determinations that remained within the normal range, and (4) clinical and/or radiographic determination of disease status at the time of last follow-up or recurrence. For statistical analyses, univariate regression models were used to compare absolute and relative changes in CA-125 levels among patients with recurrent disease and those without EOC recurrence. Results: A total of 39 patients satisfied study inclusion criteria; 22 patients manifested EOC recurrence at a median interval from complete response of 11 months. The median follow-up time from complete response to last contact was 32 months for the 17 patients in the no recurrence group. A relative increase in CA-125 of 100% (odds ratio [OR] = 23.7; 95% CI, 2.9 to 192.5; P = .003) was significantly predictive of recurrence. From baseline CA-125 nadir levels, an absolute increase in CA-125 of 5 U/mL (OR = 8.4; 95% CI, 2.2 to 32.6; P = .002) and 10 U/mL (OR = 71.2; 95% CI, 4.8 to > 999.9; P = .002) were also significantly associated with the likelihood of concurrent disease recurrence. Conclusion: Among patients with EOC in complete clinical remission, a progressive low-level increase in serum CA-125 levels is strongly predictive of disease recurrence.

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