PURPOSE: To assess the significance of CA-125 regression as a prognostic indicator and predictor of optimal cytoreduction at interval debulking surgery (IDS) in women with ovarian or primary peritoneal carcinoma receiving neoadjuvant chemotherapy (NAC). METHODS: 63 women treated between 2004 and 2007 with neoadjuvant platinum-based chemotherapy followed by IDS were studied retrospectively. Pre-operative CA-125 values were used to calculate a regression coefficient (CA-125r) using exponential regression analysis. Outcome endpoints were overall survival (OS), time to CA-125 progression (TTC) by Rustin criteria and time to second-line treatment (TTS). RESULTS: Women with a CA-125 half-life greater than 18 days had a significantly worse OS compared to those with a half-life less than 12 days on univariate testing (HR 3.34, 95% CI 1.25-8.94, p = 0.017). On multivariable analysis, CA-125r was an independent predictor of OS [HR 1.18 (per 0.01 increase in CA-125r), 95% CI 1.01-1.40, p = 0.043]. CA-125r was independently predictive of TTC and TTS (HR 1.17, p ≈ 0.03 for each). CA-125r was also predictive of achieving optimal cytoreduction at IDS (AUC 0.756, p < 0.001). CONCLUSIONS: CA-125 regression rate during pre-operative NAC is of independent prognostic value. CA-125 regression rate strongly predicts for optimal cytoreduction.
PURPOSE: To assess the significance of CA-125 regression as a prognostic indicator and predictor of optimal cytoreduction at interval debulking surgery (IDS) in women with ovarian or primary peritoneal carcinoma receiving neoadjuvant chemotherapy (NAC). METHODS: 63 women treated between 2004 and 2007 with neoadjuvant platinum-based chemotherapy followed by IDS were studied retrospectively. Pre-operative CA-125 values were used to calculate a regression coefficient (CA-125r) using exponential regression analysis. Outcome endpoints were overall survival (OS), time to CA-125 progression (TTC) by Rustin criteria and time to second-line treatment (TTS). RESULTS:Women with a CA-125 half-life greater than 18 days had a significantly worse OS compared to those with a half-life less than 12 days on univariate testing (HR 3.34, 95% CI 1.25-8.94, p = 0.017). On multivariable analysis, CA-125r was an independent predictor of OS [HR 1.18 (per 0.01 increase in CA-125r), 95% CI 1.01-1.40, p = 0.043]. CA-125r was independently predictive of TTC and TTS (HR 1.17, p ≈ 0.03 for each). CA-125r was also predictive of achieving optimal cytoreduction at IDS (AUC 0.756, p < 0.001). CONCLUSIONS:CA-125 regression rate during pre-operative NAC is of independent prognostic value. CA-125 regression rate strongly predicts for optimal cytoreduction.
Authors: Gordon J S Rustin; Michael Quinn; Tate Thigpen; Andreas du Bois; Eric Pujade-Lauraine; Anders Jakobsen; Elizabeth Eisenhauer; Satoru Sagae; Kathryn Greven; Ignace Vergote; Andres Cervantes; Jan Vermorken Journal: J Natl Cancer Inst Date: 2004-03-17 Impact factor: 13.506
Authors: Deborah K Armstrong; Brian Bundy; Lari Wenzel; Helen Q Huang; Rebecca Baergen; Shashikant Lele; Larry J Copeland; Joan L Walker; Robert A Burger Journal: N Engl J Med Date: 2006-01-05 Impact factor: 91.245
Authors: G J Rustin; A E Nelstrop; P McClean; M F Brady; W P McGuire; W J Hoskins; H Mitchell; H E Lambert Journal: J Clin Oncol Date: 1996-05 Impact factor: 44.544
Authors: Allison E Axtell; Margaret H Lee; Robert E Bristow; Sean C Dowdy; William A Cliby; Steven Raman; John P Weaver; Mojan Gabbay; Michael Ngo; Scott Lentz; Ilana Cass; Andrew J Li; Beth Y Karlan; Christine H Holschneider Journal: J Clin Oncol Date: 2007-02-01 Impact factor: 44.544
Authors: Mildred Felder; Arvinder Kapur; Jesus Gonzalez-Bosquet; Sachi Horibata; Joseph Heintz; Ralph Albrecht; Lucas Fass; Justanjyot Kaur; Kevin Hu; Hadi Shojaei; Rebecca J Whelan; Manish S Patankar Journal: Mol Cancer Date: 2014-05-29 Impact factor: 27.401