Decline of CA-125. Do we have indications and treatment guidelines? (Biologie: De?croissance du CA-125. A-t-on des indications de pilotage sur les traitements?)

摘要

This multicentric study of CA-125 kinetics under induction chemotherapy was performed on 631 patients with epithelial ovarian cancer (FIGO stage I to IV). Median (range) follow-up time was 37 months (2-222 months). CA-125 half-life was calculated by mono-compartmental logarithmic regression. Pre-chemotherapy CA-125, nadir CA-125 concentration and time to nadir were also studied. In 535 stage I-III patients pre-chemotherapy CA-125, its half-life, nadir concentration and time to nadir all had an univariate prognostic value for disease-free survival (DFS) and overall survival (OS) (p < 0.0001). In Cox models, residual tumour (p < 0.0001), stage (p < 0.0001), CA-125 half-life (p = 0.009), nadir concentration (p = 0.01) and age (p = 0.02) were prognostic factors for DFS. For OS, the significant variables were similar, without age. In stage IV patients (n = 96), CA-125 half-life and nadir had an univariate prognostic value for OS (p < 0.0001). Among well-established prognostic factors in ovarian cancers, CA-125 half-life and nadir concentration bear a strong and independent prognostic value. Springer 2006.