Risk of epithelial ovarian cancer recurrence in patients with rising serum CA-125 levels within the normal range
Risk of epithelial ovarian cancer recurrence in patients with rising serum CA-125 levels within the normal range
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DOI：
10.1200/jco.2005.02.2582
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发表时间：
2005-12-20
影响因子：
45.3
通讯作者：
Bristow, RE
中科院分区：
文献类型：
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作者：
Santillan, A;Garg, R;Bristow, RE
目的评估血清癌抗原125（CA-125）水平升高但低于正常上限的卵巢上皮癌（EOC）患者复发的风险患者和方法鉴定1997年9月至2003年3月期间接受EOC治疗的所有患者，并回顾性筛选以下内容：（1）诊断时血清CA-125升高，（2）对初始治疗有完全临床和放射学反应（CB），血清CA-125正常化，（3）至少三次连续血清CA-125测定保持在正常范围内，和（4）在最后一次随访或复发时疾病状态的临床和/或放射学测定。统计学分析采用单因素回归模型比较复发性和非复发性EOC患者CA-125水平的绝对和相对变化。结果39例患者符合研究纳入标准; 22例患者在完全缓解的中位时间间隔为11个月时出现EOC复发。对于无复发组中的17例患者，从完全缓解到末次联系的中位随访时间为32个月。CA-125相对增加100%（比值比[OB] = 23.7; 95%CI，2.9 - 192.5; P = 0.003）显著预测复发。相对于基线CA-125最低水平，CA-125绝对增加5 U/mL（OR = 8.4;95% CI，2.2 - 32.6; P = .002）和10 U/mL（OR = 71.2; 95% CI：4.8 ~> 999.9; P = 0.002）也与并发疾病复发的可能性显著相关。结论在临床完全缓解的EOC患者中，血清CA-125水平的进行性低水平升高强烈预测疾病复发。
Purpose To evaluate the risk of epithelial ovarian cancer (EOC) recurrence in patients with rising serum cancer antigen 125 (CA-125) levels that remain below the upper limit of normal (< 35 U/mL).Patients and Methods All patients treated for EOC between September 1997 and March 2003 were identified and screened retrospectively for the following: (1) elevated serum CA-125 at time of diagnosis, (2) complete clinical and radiographic response (CB) to initial treatment with normalization of serum CA-125, (3) at least three serial serum CA-125 determinations that remained within the normal range, and (4) clinical and/or radiographic determination of disease status at the time of last follow-up or recurrence. For statistical analyses, univariate regression models were used to compare absolute and relative changes in CA-125 levels among patients with recurrent disease and those without EOC recurrence,Results A total of 39 patients satisfied study inclusion criteria; 22 patients manifested EOC recurrence at a median interval from complete response of 11 months. The median follow-up time from complete response to last contact was 32 months for the 17 patients in the no recurrence group. A relative increase in CA-125 of 100% (odds ratio [OB] = 23.7; 95% Cl, 2.9 to 192.5; P = .003) was significantly predictive of recurrence. From baseline CA-125 nadir levels, an absolute increase in CA-125 of 5 U/mL (OR = 8.4;95% Cl, 2.2 to 32.6; P = .002) and 10 U/mL (OR = 71.2; 95% Cl, 4.8 to > 999.9; P = .002) were also significantly associated with the likelihood of concurrent disease recurrence.Conclusion Among patients with EOC in complete clinical remission, a progressive low-level increase in serum CA-125 levels is strongly predictive of disease recurrence.