Prognostic value of serum CA-125 in patients with advanced epithelial ovarian cancer followed by complete remission after adjuvant chemotherapy

OBJECTIVE: The aim of this study was to evaluate the prognostic value of serum CA-125 in advanced epithelial ovarian cancer with complete remission after primary adjuvant chemotherapy. METHODS: We reviewed the records of 120 patients with advanced epithelial ovarian cancer who underwent primary surgery followed by adjuvant therapy at our institution between January 1998 and December 2005. RESULTS: The median progression free survival was 21.6 months and 12.5 months in patients with nadir CA-125 levels ≤10 U/mL and 10 to 35 U/mL, respectively. Median overall survival in the same respective order was 130.2 months and 35.3 months. The level of serum CA-125 after the first cycle of adjuvant chemotherapy was most significantly higher in the recurrent group compared with the non-recurrent group. The optimal cut point of CA-125 on the receiver operating characteristic curve was 35 U/mL. Median progression free survival was 64.6 months and 12.8 months in patients with nadir CA-125 levels ≤35 U/mL and >35 U/mL, respectively, after first cycle of adjuvant chemotherapy. CONCLUSION: Serum CA-125 level after the first cycle of adjuvant chemotherapy is a strong independent prognostic factor for advanced epithelial ovarian cancer with complete response.