Department of Obstetrics & Gynecology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands.
Gynecol Oncol. 2010 Nov;119(2):265-9. doi: 10.1016/j.ygyno.2010.07.025. Epub 2010 Aug 24.
Previous reports described the prognostic value of the serum CA125 level after primary treatment (CA125 nadir) in a selection of ovarian cancer patients. Our primary objective was to determine whether the CA125 nadir level is of prognostic value on the progression-free survival (PFS) and on overall survival (OS) in epithelial ovarian cancer (EOC) patients in all stages of disease who reached complete remission (CR).
Patients were selected from a population-based study on EOC patients diagnosed between 1996 and 2006 in 11 Dutch hospitals. All 331 patients who reached CR (i.e. no physical or radiological signs of residual disease and CA125 values ≤35 kU/L) after primary treatment were included. The Kaplan-Meier survival curves of PFS and OS in CA125 nadir ≤5 kU/L and >5 kU/L were compared using the log-rank test. Multivariate Cox regression analyses were performed to study the factors that independently influence survival.
A CA125 nadir ≤5 kU/L (n=69) was significantly associated with both a longer PFS and longer OS (log-rank test P<0.01 and P=0.03, respectively). The CA125 nadir was an independent prognostic variable (HR=1.51, 95% CI: 1.04-2.31) for PFS next to histological type, FIGO stage and residual tumor after surgery.
EOC patients who were in CR after standard primary treatment and attained CA125 nadir values of ≤5 kU/L had a significantly longer PFS and OS. Moreover, the CA125 nadir of ≤5 kU/L is an independent predictor of tumor recurrence.
之前的报告描述了原发性治疗后（CA125 最低点）血清 CA125 水平在部分卵巢癌患者中的预后价值。我们的主要目的是确定在达到完全缓解（CR）的所有疾病阶段的上皮性卵巢癌（EOC）患者中，CA125 最低点水平是否对无进展生存期（PFS）和总生存期（OS）具有预后价值。
从 1996 年至 2006 年在 11 家荷兰医院诊断的 EOC 患者的基于人群的研究中选择患者。所有在原发性治疗后达到 CR（即无残留疾病的体格检查或影像学迹象且 CA125 值≤35 kU/L）的 331 例患者均被纳入研究。使用对数秩检验比较 CA125 最低点≤5 kU/L 和>5 kU/L 患者的 PFS 和 OS 的 Kaplan-Meier 生存曲线。进行多变量 Cox 回归分析以研究独立影响生存的因素。
CA125 最低点≤5 kU/L（n=69）与更长的 PFS 和 OS 显著相关（对数秩检验 P<0.01 和 P=0.03）。CA125 最低点是除组织学类型、FIGO 分期和手术后残留肿瘤外，预测 PFS 的独立预后因素（HR=1.51，95%CI：1.04-2.31）。
在标准原发性治疗后达到 CR 且 CA125 最低点值≤5 kU/L 的 EOC 患者的 PFS 和 OS 显著延长。此外，CA125 最低点值≤5 kU/L 是肿瘤复发的独立预测因素。
