CA-125 Levels Are Predictive of Survival in Low-Grade Serous Ovarian Cancer-A Multicenter Analysis

Wohlmuth, C; Djedovic, V; Kjaer, SK; Jensen, A; Glasspool, R; Roxburgh, P; DeFazio, A; Johnatty, SE; Webb, PM; Modugno, F; Lambrechts, D; Schildkraut, JM; Berchuck, A; Thomsen, LCV; Bjorge, L; Hogdall, E; Hogdall, CK; Goode, EL; Winham, SJ; Matsuo, K; Karlan, BY; Lester, J; Goodman, MT; Thompson, PJ; Pejovic, T; Riggan, MJ; Lajkosz, K; Tone, A; May, T

Author(s): Wohlmuth, C; Djedovic, V; Kjaer, SK; Jensen, A; Glasspool, R; Roxburgh, P; DeFazio, A; Johnatty, SE; Webb, PM; Modugno, F; Lambrechts, D; Schildkraut, JM; Berchuck, A; Thomsen, LCV; Bjorge, L; Hogdall, E; Hogdall, CK; Goode, EL; Winham, SJ; Matsuo, K; Karlan, BY; Lester, J; Goodman, MT; Thompson, PJ; Pejovic, T; Riggan, MJ; Lajkosz, K; Tone, A; May, T;
Details: Publication Year 2022-04-13,Volume 14,Issue #8,Page 1954
Journal Title: Cancers
Publication Type: Research article
Abstract: 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.
Keywords: Ca-125; low-grade serous cancer; ovarian cancer; survival
Department(s): Laboratory Research
PubMed ID: 35454861
Publisher's Version: https://doi.org/10.3390/cancers14081954
Open Access at Publisher's Site: https://doi.org/10.3390/cancers14081954
Terms of Use/Rights Notice: Refer to copyright notice on published article.

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