PREOPERATIVE CA-125 - AN INDEPENDENT PROGNOSTIC FACTOR IN PATIENTS WITH STAGE-I EPITHELIAL OVARIAN-CANCER
PREOPERATIVE CA-125 - AN INDEPENDENT PROGNOSTIC FACTOR IN PATIENTS WITH STAGE-I EPITHELIAL OVARIAN-CANCER
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DOI：
10.1016/0029-7844(95)00126-c
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发表时间：
1995-08-01
影响因子：
7.2
通讯作者：
SEVELDA, P
中科院分区：
文献类型：
--
作者：
NAGELE, F;PETRU, E;SEVELDA, P
目的：评估术前CA 125水平对国际妇产科联合会（FIGO）I期上皮性卵巢癌患者的预后重要性，并与已确定的预后因素（分化程度、FIGO亚期和年龄）进行比较。在回顾性分析中，传统的预后因素和CA 125水平（临界值65 U/mL）在1984-1993年期间在5个中心接受治疗的201例患者中进行了研究。交界性肿瘤或非上皮性卵巢癌的患者被排除在外，因为是妇女在其中CA 125没有被确定preoperatives.Results：在单变量分析（Mantel检验），总生存率显着下降，在CA 125阳性的患者（P <0.001）。亚期（P = 0.004）和组织学分级（P = 0.01）也显著影响生存预后。当术前CA 125水平的影响与组织学分级相关时，CA 125水平等于或大于65 U/mL的所有三个亚组与生存概率降低相关（1级，P = .04; 2级，P = .003; 3级，P = .01）。多变量分析（考克斯模型）确定术前CA 125是影响生存率的最强预后因素（P <0.001），CA 125阳性患者死于疾病的风险高6.37倍（95%置信区间2.39-16.97）。虽然FIGO分期保留其显着的影响，生存（P = .03），组织学分级和年龄并不显着importantic.Conclusion：随机试验研究辅助治疗皮科I期上皮性卵巢癌患者的疗效还应包括分层术前CA 125水平。
Objective: To evaluate the prognostic importance of preoperative CA 125 levels in patients with International Federation of Gynecology and Obstetrics (FIGO) stage I epithelial ovarian cancer in comparison with the established prognostic factors: degree of differentiation, FIGO substage, and age.Methods: In a retrospective analysis, the traditional prognostic factors and CA 125 levels (cutoff value 65 U/mL) were studied in 201 patients who were treated in five centers during 1984-1993. Patients with borderline tumors or nonepithelial ovarian carcinomas were excluded, as were women in whom CA 125 had not been determined preoperatively.Results: In univariate analysis (Mantel test), overall survival decreased significantly in patients positive for CA 125 (P < .001). Substage (P = .004) and histologic grade (P = .01) also significantly influenced survival prognosis. When the effects of preoperative CA 125 levels were correlated with histologic grade, all three subgroups with CA 125 levels equal to or greater than 65 U/mL were associated with a decreased survival probability (grade 1, P = .04; grade 2, P = .003; grade 3, P = .01). Multivariate analysis (Cox model) identified preoperative CA 125 as the most powerful prognostic factor for survival (P < .001), the risk of dying of disease being 6.37 times higher (95% confidence interval 2.39-16.97) in CA 125-positive patients. Although FIGO substage retained its significant influence on survival (P = .03), histologic grade and age were not prognostically important.Conclusion: Randomized trials investigating the efficacy of adjuvant treatment in patients with PICO stage I epithelial ovarian cancer should also include stratification by preoperative CA 125 levels.