BACKGROUND: This meta-analysis was designed to determine the ability of pretreatment CA-125 level to predict optimal cytoreduction in advanced ovarian cancer (OC). METHODS: Through literature search, 14 studies were identified. In addition, we retrospectively reviewed the data of 154 patients with OC. Using the bi-variate model, diagnostic performance of CA-125 was assessed at the various cut-off levels. An overall odds ratio was obtained using random effects model. RESULTS: A total of 2,192 patients were included in the analysis. The pooled optimal cytoreduction rate and the mean of median CA-125 levels were 53.7% and 580 U/ml, respectively. At the cut-off of 500 U/ml, overall sensitivity and specificity were 68.9% (95% confidence interval [CI] 62.0-75.1%) and 63.2% (95% CI 53.7-71.7%), respectively. Positive and negative likelihood ratios were 1.87 (95% CI 1.40-2.50) and 0.49 (95% CI 0.37-0.66). The CA-125 >500 U/ml showed strong association with a risk of suboptimal cytoreduction with an odds ratio of 3.69 (95% CI 2.02-6.73). CONCLUSIONS: The current analysis indicates that CA-125 is a strong risk factor of suboptimal cytoreduction and it may be applied in preoperative counseling and treatment planning. However, it also shows that CA-125 lacks the ability to predict optimal cytoreduction accurately.
BACKGROUND: This meta-analysis was designed to determine the ability of pretreatment CA-125 level to predict optimal cytoreduction in advanced ovarian cancer (OC). METHODS: Through literature search, 14 studies were identified. In addition, we retrospectively reviewed the data of 154 patients with OC. Using the bi-variate model, diagnostic performance of CA-125 was assessed at the various cut-off levels. An overall odds ratio was obtained using random effects model. RESULTS: A total of 2,192 patients were included in the analysis. The pooled optimal cytoreduction rate and the mean of median CA-125 levels were 53.7% and 580 U/ml, respectively. At the cut-off of 500 U/ml, overall sensitivity and specificity were 68.9% (95% confidence interval [CI] 62.0-75.1%) and 63.2% (95% CI 53.7-71.7%), respectively. Positive and negative likelihood ratios were 1.87 (95% CI 1.40-2.50) and 0.49 (95% CI 0.37-0.66). The CA-125 >500 U/ml showed strong association with a risk of suboptimal cytoreduction with an odds ratio of 3.69 (95% CI 2.02-6.73). CONCLUSIONS: The current analysis indicates that CA-125 is a strong risk factor of suboptimal cytoreduction and it may be applied in preoperative counseling and treatment planning. However, it also shows that CA-125 lacks the ability to predict optimal cytoreduction accurately.
Authors: Susan L Tucker; Kshipra Gharpure; Shelley M Herbrich; Anna K Unruh; Alpa M Nick; Erin K Crane; Robert L Coleman; Jamie Guenthoer; Heather J Dalton; Sherry Y Wu; Rajesha Rupaimoole; Gabriel Lopez-Berestein; Bulent Ozpolat; Cristina Ivan; Wei Hu; Keith A Baggerly; Anil K Sood Journal: Clin Cancer Res Date: 2014-04-22 Impact factor: 12.531
Authors: Iván Díaz-Padilla; Albiruni Ryan Abdul Razak; Lucas Minig; Marcus Q Bernardini; Josep María Del Campo Journal: Clin Transl Oncol Date: 2012-01 Impact factor: 3.405
Authors: Natalia Rodriguez Gómez-Hidalgo; Bertha Alejandra Martinez-Cannon; Alpa M Nick; Karen H Lu; Anil K Sood; Robert L Coleman; Pedro T Ramirez Journal: Gynecol Oncol Date: 2015-03-28 Impact factor: 5.482
Authors: Dina Mury; Linn Woelber; Sabine Jung; Christine Eulenburg; Matthias Choschzick; Isabell Witzel; Joerg Schwarz; Fritz Jaenicke; Sven Mahner Journal: J Cancer Res Clin Oncol Date: 2011-02-23 Impact factor: 4.553
Authors: Alexi A Wright; Kari Bohlke; Deborah K Armstrong; Michael A Bookman; William A Cliby; Robert L Coleman; Don S Dizon; Joseph J Kash; Larissa A Meyer; Kathleen N Moore; Alexander B Olawaiye; Jessica Oldham; Ritu Salani; Dee Sparacio; William P Tew; Ignace Vergote; Mitchell I Edelson Journal: Gynecol Oncol Date: 2016-08-08 Impact factor: 5.482
Authors: Alexi A Wright; Kari Bohlke; Deborah K Armstrong; Michael A Bookman; William A Cliby; Robert L Coleman; Don S Dizon; Joseph J Kash; Larissa A Meyer; Kathleen N Moore; Alexander B Olawaiye; Jessica Oldham; Ritu Salani; Dee Sparacio; William P Tew; Ignace Vergote; Mitchell I Edelson Journal: J Clin Oncol Date: 2016-08-08 Impact factor: 44.544