CA-125 levels are predictive of survival in low-grade serous ovarian cancer—a multicenter analysis

Wohlmuth, C. et al. (2022) CA-125 levels are predictive of survival in low-grade serous ovarian cancer—a multicenter analysis. Cancers, 14(8), 1954. (doi: 10.3390/cancers14081954)

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Objective: Studies on low-grade serous ovarian cancer (LGSC) are limited by a low number of cases. The aim of this study was to define the prognostic significance of age, stage, and CA-125 levels on survival in a multi-institutional cohort of women with pathologically confirmed LGSC. Methods: Women with LGSC were identified from the collaborative Ovarian Cancer Association Consortium (OCAC). Cases of newly diagnosed primary LGSC were included if peri-operative CA-125 levels were available. Age at diagnosis, FIGO stage, pre- and post-treatment CA-125 levels, residual disease, adjuvant chemotherapy, disease recurrence, and vital status were collected by the participating institutions. Progression-free (PFS) and overall survival (OS) were calculated. Multivariable (MVA) Cox proportional hazard models were used and hazard ratios (HR) calculated. Results: A total of 176 women with LGSC were included in this study; 82% had stage III/IV disease. The median PFS was 2.3 years and the median OS was 6.4 years. Age at diagnosis was not significantly associated with worse PFS (p = 0.23) or OS (p = 0.3) (HR per year: 0.99; 95%CI, 0.96−1.01 and 0.98; 95%CI 0.95−1.01). FIGO stage III/IV was independently associated with PFS (HR 4.26, 95%CI 1.43−12.73) and OS (HR 1.69, 95%CI 0.56−5.05). Elevated CA-125 (≥35 U/mL) at diagnosis was not significantly associated with worse PFS (p = 0.87) or OS (p = 0.78) in MVA. Elevated CA-125 (≥35 U/mL) after completion of primary treatment was independently associated with worse PFS (HR 2.81, 95%CI 1.36−5.81) and OS (HR 6.62, 95%CI 2.45−17.92). In the MVA, residual disease was independently associated with PFS (0.022), but not OS (0.85). Conclusion: Advanced LGSC was associated with poor long-term prognosis. FIGO stage and abnormal post-treatment CA-125 level are key prognostic factors inversely associated with PFS and OS. Highlights: 1. Through a multi-center collaborative effort, data from 176 women with low-grade serous ovarian cancer were analyzed. 2. Although low-grade serous ovarian cancer is often considered indolent, the progression-free and overall survival are poor. 3. Elevated post-treatment CA-125 levels are independently associated with poor survival.

Item Type:Articles
Keywords:Ovarian cancer, low-grade serous cancer, CA-125, survival.
Glasgow Author(s) Enlighten ID:Roxburgh, Dr Patricia and Glasspool, Dr Rosalind
Authors: Wohlmuth, C., Djedovic, V., Kjaer, S. K., Jensen, A., Glasspool, R., Roxburgh, P., DeFazio, A., Johnatty, S. E., Webb, P. M., Modugno, F., Lambrechts, D., Schildkraut, J. M., Berchuck, A., Thomsen, L. C. V., Bjorge, L., Høgdall, E., Høgdall, C. K., Goode, E. L., Winham, S. J., Matsuo, K., Karlan, B. Y., Lester, J., Goodman, M. T., Thompson, P. J., Pejovic, T., Riggan, M. J., Lajkosz, K., Tone, A., and May, T.
College/School:College of Medical Veterinary and Life Sciences > School of Cancer Sciences
Journal Name:Cancers
ISSN (Online):2072-6694
Published Online:13 April 2022
Copyright Holders:Copyright © 2022 The Authors
First Published:First published in Cancers 14(8): 1954
Publisher Policy:Reproduced under a Creative Commons License

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