The prognostic value of pretreatment CA 125 in patients with advanced ovarian carcinoma

A gynecologic oncology group study

Kristin K. Zorn, Chunqiao Tian, William P. McGuire, William J. Hoskins, Maurie Markman, Franco M. Muggia, Peter G. Rose, Robert F. Ozols, David Spriggs, Deborah Kay Armstrong

Research output: Contribution to journalArticle

Abstract

BACKGROUND: The objective of the current study was to determine the prognostic significance of a pretreatment serum CA 125 level in patients with advanced epithelial ovarian carcinoma (EOC) who received treatment with a standard chemotherapy regimen. METHODS: Patients with International Federation of Gynecology and Obstetrics stage III/IV ovarian carcinoma who were on 1 of 7 Gynecologic Oncology Group (GOG) phase 3 trials and received treatment with a standard regimen of Intravenous cisplatin and paclitaxel were included. A Cox regression model was used to assess the impact of CA 125 levels drawn before the initiation of chemotherapy on progression-free survival (PFS) both overall and by subgroup, including surgical debulking status, disease stage, and histologic subtype, RESULTS: In total, 1299 patients who were on the cisplatin/ paclitaxel arms of the GOG trials were eligible. The median CA 125 level was 246 U/mL. Only 7.6% of patients had a normal CA 125 level (≤35 U/mL), The lowest median CA 125 level was observed in the group with mucinous tumors; however, 69% of women who had mucinous tumors had abnormal CA 125 levels, Shorter PFS was observed with increasing CA 125 and persisted in multivariate analysis, Overall and in the serous subgroup, a 1-fold increase in CA 125 level was associated with a 7% increase in the hazard of disease progression (P <.001). This association was even more pronounced in patients who had stage III disease that was debulked to microscopic disease (15%; P = .003) and in patients who had endometrioid tumors (17%; P = .001). CONCLUSIONS: A normal CA 125 level In the setting of advanced EOC was rare even after surgical debulking. The pretreatment CA 125 level was an independent predictor of PFS in patients with advanced EOC who received a standard chemotherapy regimen, particularly in the setting of disease that was debulked to a microscopic residual and in the serous or endometrioid subtypes.

Original languageEnglish (US)
Pages (from-to)1028-1035
Number of pages8
JournalCancer
Volume115
Issue number5
DOIs
StatePublished - Mar 1 2009

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Carcinoma
Disease-Free Survival
Drug Therapy
Neoplasms
Gynecology
Proportional Hazards Models
Obstetrics
Disease Progression
Multivariate Analysis
Therapeutics
Serum
TP protocol

Keywords

  • CA 125 tumor marker
  • Epithelial ovarian cancer
  • Gynecologic Oncology Group
  • Progression-free survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

The prognostic value of pretreatment CA 125 in patients with advanced ovarian carcinoma : A gynecologic oncology group study. / Zorn, Kristin K.; Tian, Chunqiao; McGuire, William P.; Hoskins, William J.; Markman, Maurie; Muggia, Franco M.; Rose, Peter G.; Ozols, Robert F.; Spriggs, David; Armstrong, Deborah Kay.

In: Cancer, Vol. 115, No. 5, 01.03.2009, p. 1028-1035.

Research output: Contribution to journalArticle

Zorn, KK, Tian, C, McGuire, WP, Hoskins, WJ, Markman, M, Muggia, FM, Rose, PG, Ozols, RF, Spriggs, D & Armstrong, DK 2009, 'The prognostic value of pretreatment CA 125 in patients with advanced ovarian carcinoma: A gynecologic oncology group study', Cancer, vol. 115, no. 5, pp. 1028-1035. https://doi.org/10.1002/cncr.24084
Zorn, Kristin K. ; Tian, Chunqiao ; McGuire, William P. ; Hoskins, William J. ; Markman, Maurie ; Muggia, Franco M. ; Rose, Peter G. ; Ozols, Robert F. ; Spriggs, David ; Armstrong, Deborah Kay. / The prognostic value of pretreatment CA 125 in patients with advanced ovarian carcinoma : A gynecologic oncology group study. In: Cancer. 2009 ; Vol. 115, No. 5. pp. 1028-1035.
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title = "The prognostic value of pretreatment CA 125 in patients with advanced ovarian carcinoma: A gynecologic oncology group study",
abstract = "BACKGROUND: The objective of the current study was to determine the prognostic significance of a pretreatment serum CA 125 level in patients with advanced epithelial ovarian carcinoma (EOC) who received treatment with a standard chemotherapy regimen. METHODS: Patients with International Federation of Gynecology and Obstetrics stage III/IV ovarian carcinoma who were on 1 of 7 Gynecologic Oncology Group (GOG) phase 3 trials and received treatment with a standard regimen of Intravenous cisplatin and paclitaxel were included. A Cox regression model was used to assess the impact of CA 125 levels drawn before the initiation of chemotherapy on progression-free survival (PFS) both overall and by subgroup, including surgical debulking status, disease stage, and histologic subtype, RESULTS: In total, 1299 patients who were on the cisplatin/ paclitaxel arms of the GOG trials were eligible. The median CA 125 level was 246 U/mL. Only 7.6{\%} of patients had a normal CA 125 level (≤35 U/mL), The lowest median CA 125 level was observed in the group with mucinous tumors; however, 69{\%} of women who had mucinous tumors had abnormal CA 125 levels, Shorter PFS was observed with increasing CA 125 and persisted in multivariate analysis, Overall and in the serous subgroup, a 1-fold increase in CA 125 level was associated with a 7{\%} increase in the hazard of disease progression (P <.001). This association was even more pronounced in patients who had stage III disease that was debulked to microscopic disease (15{\%}; P = .003) and in patients who had endometrioid tumors (17{\%}; P = .001). CONCLUSIONS: A normal CA 125 level In the setting of advanced EOC was rare even after surgical debulking. The pretreatment CA 125 level was an independent predictor of PFS in patients with advanced EOC who received a standard chemotherapy regimen, particularly in the setting of disease that was debulked to a microscopic residual and in the serous or endometrioid subtypes.",
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author = "Zorn, {Kristin K.} and Chunqiao Tian and McGuire, {William P.} and Hoskins, {William J.} and Maurie Markman and Muggia, {Franco M.} and Rose, {Peter G.} and Ozols, {Robert F.} and David Spriggs and Armstrong, {Deborah Kay}",
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T1 - The prognostic value of pretreatment CA 125 in patients with advanced ovarian carcinoma

T2 - A gynecologic oncology group study

AU - Zorn, Kristin K.

AU - Tian, Chunqiao

AU - McGuire, William P.

AU - Hoskins, William J.

AU - Markman, Maurie

AU - Muggia, Franco M.

AU - Rose, Peter G.

AU - Ozols, Robert F.

AU - Spriggs, David

AU - Armstrong, Deborah Kay

PY - 2009/3/1

Y1 - 2009/3/1

N2 - BACKGROUND: The objective of the current study was to determine the prognostic significance of a pretreatment serum CA 125 level in patients with advanced epithelial ovarian carcinoma (EOC) who received treatment with a standard chemotherapy regimen. METHODS: Patients with International Federation of Gynecology and Obstetrics stage III/IV ovarian carcinoma who were on 1 of 7 Gynecologic Oncology Group (GOG) phase 3 trials and received treatment with a standard regimen of Intravenous cisplatin and paclitaxel were included. A Cox regression model was used to assess the impact of CA 125 levels drawn before the initiation of chemotherapy on progression-free survival (PFS) both overall and by subgroup, including surgical debulking status, disease stage, and histologic subtype, RESULTS: In total, 1299 patients who were on the cisplatin/ paclitaxel arms of the GOG trials were eligible. The median CA 125 level was 246 U/mL. Only 7.6% of patients had a normal CA 125 level (≤35 U/mL), The lowest median CA 125 level was observed in the group with mucinous tumors; however, 69% of women who had mucinous tumors had abnormal CA 125 levels, Shorter PFS was observed with increasing CA 125 and persisted in multivariate analysis, Overall and in the serous subgroup, a 1-fold increase in CA 125 level was associated with a 7% increase in the hazard of disease progression (P <.001). This association was even more pronounced in patients who had stage III disease that was debulked to microscopic disease (15%; P = .003) and in patients who had endometrioid tumors (17%; P = .001). CONCLUSIONS: A normal CA 125 level In the setting of advanced EOC was rare even after surgical debulking. The pretreatment CA 125 level was an independent predictor of PFS in patients with advanced EOC who received a standard chemotherapy regimen, particularly in the setting of disease that was debulked to a microscopic residual and in the serous or endometrioid subtypes.

AB - BACKGROUND: The objective of the current study was to determine the prognostic significance of a pretreatment serum CA 125 level in patients with advanced epithelial ovarian carcinoma (EOC) who received treatment with a standard chemotherapy regimen. METHODS: Patients with International Federation of Gynecology and Obstetrics stage III/IV ovarian carcinoma who were on 1 of 7 Gynecologic Oncology Group (GOG) phase 3 trials and received treatment with a standard regimen of Intravenous cisplatin and paclitaxel were included. A Cox regression model was used to assess the impact of CA 125 levels drawn before the initiation of chemotherapy on progression-free survival (PFS) both overall and by subgroup, including surgical debulking status, disease stage, and histologic subtype, RESULTS: In total, 1299 patients who were on the cisplatin/ paclitaxel arms of the GOG trials were eligible. The median CA 125 level was 246 U/mL. Only 7.6% of patients had a normal CA 125 level (≤35 U/mL), The lowest median CA 125 level was observed in the group with mucinous tumors; however, 69% of women who had mucinous tumors had abnormal CA 125 levels, Shorter PFS was observed with increasing CA 125 and persisted in multivariate analysis, Overall and in the serous subgroup, a 1-fold increase in CA 125 level was associated with a 7% increase in the hazard of disease progression (P <.001). This association was even more pronounced in patients who had stage III disease that was debulked to microscopic disease (15%; P = .003) and in patients who had endometrioid tumors (17%; P = .001). CONCLUSIONS: A normal CA 125 level In the setting of advanced EOC was rare even after surgical debulking. The pretreatment CA 125 level was an independent predictor of PFS in patients with advanced EOC who received a standard chemotherapy regimen, particularly in the setting of disease that was debulked to a microscopic residual and in the serous or endometrioid subtypes.

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KW - Epithelial ovarian cancer

KW - Gynecologic Oncology Group

KW - Progression-free survival

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