A Longitudinal Analysis with CA-125 to Predict Overall Survival in Patients with Ovarian Cancer

Overview

Journal J Gynecol Oncol

Specialties Gynecology & Obstetrics
Oncology

Date 2014 Jan 25

PMID 24459581

Citations 7

Authors

An Jen Chiang

Jiabin Chen

Yu-Che Chung

Huan-Jung Huang

Wen Shiung Liou

Chung Chang

Affiliations

Soon will be listed here.

Abstract

Objective: The objective of this study was to explore the association of longitudinal CA-125 measurements with overall survival (OS) time by developing a flexible model for patient-specific CA-125 profiles, and to provide a simple and reliable prediction of OS.

Methods: A retrospective study was performed on 275 patients with ovarian cancer who underwent at least one cycle of primary chemotherapy in our institute. Serial measurements of patients' CA-125 levels were performed at different frequencies according to their clinical plans. A statistical model coupling the Cox proportional hazards and the mixed-effects models was applied to determine the association of OS with patient-specific longitudinal CA-125 values. Stage and residual tumor size were additional variables included in the analysis.

Results: A total of 1,601 values of CA-125 were included. Longitudinal CA-125 levels, stage, and the residual tumor size were all significantly associated with OS. A patient-specific survival probability could be calculated. Validation showed that, in average, 85.4% patients were correctly predicted to have a high or low risk of death at a given time point. Comparison with a traditional model using CA-125 half-life and time to reach CA-125 nadir showed that the longitudinal CA-125 model had an improved predicative value.

Conclusion: Longitudinal CA-125 values, measured from the diagnosis of ovarian cancer to the completion of primary chemotherapy, could be used to reliably predict OS after adjusting for the stage and residual tumor disease. This model could be potentially useful in clinical counseling of patients with ovarian cancer.

Citing Articles

The Role of CA-125 in the Management of Ovarian Cancer: A Systematic Review.

Momenimovahed Z, Mazidimoradi A, Allahqoli L, Salehiniya H Cancer Rep (Hoboken). 2025; 8(3):e70142.

PMID: 40067023 PMC: 11894717. DOI: 10.1002/cnr2.70142.

Dynamic Prediction of Resectability for Patients with Advanced Ovarian Cancer Undergoing Neo-Adjuvant Chemotherapy: Application of Joint Model for Longitudinal CA-125 Levels.

Amroun K, Chaltiel R, Reyal F, Kianmanesh R, Savoye A, Perrier M Cancers (Basel). 2023; 15(1).

PMID: 36612234 PMC: 9818430. DOI: 10.3390/cancers15010231.

The Effect of Delayed Chemotherapy on the Decrease of CA125 in Epithelial Ovarian Cancer During Coronavirus Disease Pandemic in 2020.

Yi Q, Ran Y, Li C Cancer Manag Res. 2021; 13:515-520.

PMID: 33500665 PMC: 7826069. DOI: 10.2147/CMAR.S289773.

A reactive oxygen species scoring system predicts cisplatin sensitivity and prognosis in ovarian cancer patients.

Sun C, Guo E, Zhou B, Shan W, Huang J, Weng D BMC Cancer. 2019; 19(1):1061.

PMID: 31703584 PMC: 6839150. DOI: 10.1186/s12885-019-6288-7.

Integrated multiomic predictors for ovarian cancer survival.

Fu A, Chang H, Zhang Z Carcinogenesis. 2018; 39(7):860-868.

PMID: 29897425 PMC: 6031025. DOI: 10.1093/carcin/bgy055.

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