Predictive value of serum CA125 following optimal cytoreductive surgery during weekly cisplatin induction therapy for advanced ovarian cancer
| Autor: | Nachimuthu Natarajan, M. L. Hicks, Trudy R. Baker, M. S. Piver, Ronald E. Hempling, J. M. Thompson, C. Mettlin |
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| Rok vydání: | 1993 |
| Předmět: |
Adult
Reoperation medicine.medical_specialty Time Factors endocrine system diseases Cyclophosphamide Ovariectomy medicine.medical_treatment New York Urology Sensitivity and Specificity Antineoplastic Combined Chemotherapy Protocols Confidence Intervals medicine Humans Combined Modality Therapy Antigens Tumor-Associated Carbohydrate Prospective Studies Stage (cooking) Prospective cohort study Aged Retrospective Studies Aged 80 and over Ovarian Neoplasms Postoperative Care Cisplatin Chemotherapy business.industry Retrospective cohort study General Medicine Middle Aged Prognosis female genital diseases and pregnancy complications Confidence interval Surgery Oncology Doxorubicin Regression Analysis Female business medicine.drug |
| Zdroj: | Journal of Surgical Oncology. 54:38-44 |
| ISSN: | 1096-9098 0022-4790 |
| DOI: | 10.1002/jso.2930540111 |
| Popis: | One hundred seventy-one patients with epithelial ovarian cancer were treated on a prospective protocol of weekly cisplatin induction (1 mg/kg weekly for four courses) followed by monthly cisplatin (50 mg/m2), Adriamycin (50 mg/m2), and cyclophosphamide (750 mg/m2). Seventy-five patients with FIGO stage III or IV disease who underwent optimal cytoreductive surgery (2 cm residual disease) were treated on this protocol and had weekly as well as monthly serum CA125 levels measured. A retrospective analysis was performed in order to determine if aor = 50% fall in elevated serum CA125 levels during weekly cisplatin induction therapy would be predictive of findings at second look operation, normalization of serum CA125 levels (35 u/ml) immediately prior to the third course of multiagent chemotherapy, and to determine the impact of such a decline on median progression-free interval. Positive predictive values for this parameter with respect to findings at second look operation ranged between 38% and 50% (P0.05). Positive predictive values for this parameter with respect to normalization of serum CA125 levels immediately prior to the third course of multiagent chemotherapy ranged between 64.2% and 89.6% (P0.05). Logistic regression analysis demonstrated that aor = 50% fall observed in CA125 levels during four weekly courses of chemotherapy served as an independent predictor of normalization of serum CA125 levels (35 u/ml) following two courses of multiagent chemotherapy (P = 0.009) and improved median progression-free interval (P = 0.04). Eighteen patients demonstrated a rise in serum CA125 levels during weekly induction cisplatin chemotherapy. Only one of these patients (5.5%) demonstrated a surgical complete response at the end of standard therapy. |
| Databáze: | OpenAIRE |
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