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CA 125 half-life and CA 125 nadir during induction chemotherapy are independent predictors of epithelial ovarian cancer outcome: results of a French multicentric study

2006; Elsevier BV; Volume: 17; Issue: 8 Linguagem: Inglês

10.1093/annonc/mdl120

1569-8041

Jean‐Marc Riedinger, J Wafflart, Gabriel Ricolleau, N. Eche, H Larbre, J P Basuyau, I Dalifard, K. Hacène, M. Pichon,

Renal cell carcinoma treatment

Background: CA 125 assays enable treatment-response monitoring in ovarian cancer.Patients and methods: A multicentric study of CA 125 kinetics under induction chemotherapy was performed in 631 patients. CA 125 half-life was calculated by mono-compartmental logarithmic regression. Nadir CA 125 concentration and time to nadir were also studied. Survival analyses for disease-free survival (DFS) and overall survival (OS) used univariate (Kaplan-Meier) and multivariate (Cox) models.Results: For 553 stage IIC–IV patients, 459 (83.0%) relapsed and 444 (80.3%) died from cancer. Median (range) follow up time was 32 months (2–214 months). Median (range) for CA 125 kinetics were: 263 kU/l (5–52000 kU/l) before 1st course, 15.8 days (4.5–417.9 days) for CA 125 half-life, 16 kU/l (3–2610 kU/l) for nadir and 85 days (0–361 days) for time to nadir. Pre-chemotherapy CA 125, its half-life, nadir concentration and time to nadir all had a univariate prognostic value for DFS and OS (P < 0.0001). In Cox models, CA 125 half-life, residual tumour (P < 0.0001 for both), nadir concentration (P = 0.0002) and stage (P = 0.0118) were the most powerful prognostic factors for DFS. For OS, the significant variables were similar, with age ranking last (P = 0.0319).Conclusion: Among well-established prognostic factors in ovarian cancers, CA 125 half-life and nadir concentration bear a strong and independent prognostic value.