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Sub-category:
Ovarian Cancer
Category:
Gynecologic Cancer
Meeting:
2009 ASCO Annual Meeting
Abstract No:
e16521
Citation:
J Clin Oncol 27, 2009 (suppl; abstr e16521)
Author(s):
F. AbuShain, P. Escobar, S. Shahabi, C. Michener, R. Drake, P. G. Rose, P. E. Schwartz; Cleveland Clinic, Cleveland, OH; Albert Einstein College of Medicine, Bronx, NY; Yale University, New Haven, CT
Abstract:
Background: Small published series suggested that three progressively rising CA-125 values, doubling of CA-125, and an absolute rise of 5 U/mL from the nadir, all while remaining in the normal range were highly associated with disease recurrence. This study aims to validate these proposed criteria in a larger population. Methods: We conducted a retrospective review of the records of patients with stages IIIC and IV epithelial ovarian cancer treated with primary surgery and adjuvant chemotherapy between 1994 and 2006. Only patients who had a complete response to chemotherapy verified by normal CT scan, CA-125 and physical examination were included. Nadir CA-125 level was defined as the first CA-125 measurement after completing chemotherapy. Available CA-125 values from diagnosis to recurrence or to last follow up were collected and evaluated for meeting any of the criteria above. Results: 91 patients with a median age of 59 (42 - 88) met the inclusion criteria. 82 patients had stage IIIC (90%) and 9 patients (10%) had stage IV. 86 patients (94.5%) had papillary serous histology and 88 patients had grade 3 (96.7%) disease. Median follow up was 43.7 months (12.6 - 156). Table 1 shows the number of patients who met any of the above CA-125 criteria in total and divided by the presence or absence of recurrence. There was no statistically significant difference in meeting any of the CA-125 criteria between the recurrence and no recurrence groups. Meeting at least one of the CA-125 criteria had 50% sensitivity, 65% specificity, and 86% positive predictive value for recurrence. The median time to recurrence in patients who met at least one CA-125 criteria was 3.8 months (0.2 - 12.4) and the median follow up time after meeting one of the CA 125 criteria in patients who did not recur was 88.5 months (10.4 - 188) Conclusions: Rising CA-125 levels within the normal range that meet any of the above criteria are highly predictive (86%) of recurrence within 12 months and closer observation is warranted.
| | All patients (%) | Patients with
recurrence (%) | Patients with
no recurrence (%) | P |
| | N | 91 | 74 (81.3) | 17 (18.7) | | | Absolute rise of 5 U/mL | 41 (45) | 35 (47.3) | 6 (35.3) | NS* | | Doubling | 25 (27.5) | 22 (29.7) | 3 (17.7) | NS | | Three progressively rising values | 24 (26.4) | 20 (27) | 4 (23.5) | NS | | Met at least one criterion | 43 (47.3) | 37 (50%) | 6 (35.3) | NS |
| | * NS: not statistically significant P > 0.05 |
Abstract Disclosures
Faculty and Discussant Disclosures
Annual Meeting Planning Committee Disclosures
2009 Annual Meeting Proceedings Part I Errata
Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy
and are designated with a caret symbol (^) here and in the print version.
 Associated Presentation(s):
Other Abstracts in this Sub-Category:
Abstracts by F. AbuShain:
Presentations by F. AbuShain:
Educational Book Manuscripts by F. AbuShain:
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