Prediction effects of serum CA125 decrease ratio during different cycles in relapsed ovarian cancer.

AIM: To investigate the prognostic value of serum cancer antigen 125 (CA125) levels during chemotherapy in relapsed epithelial ovarian cancer (EOC) and to identify cut-off values that distinguish patients who relapse beyond 12 months from those who relapse within 12 months.

METHODS: About 93 relapsed EOC patients who received cytoreductive surgery and adjuvant chemotherapy at Obstetrics and Gynecology Hospital of Fudan University between January 2003 and March 2015 were selected. Univariate regression analysis was used to determine the significant prognostic factors. The Kaplan-Meier method was used to calculate the overall survival (OS) rate.

RESULTS: The CA125 decrease ratio of more than 97.6% after the fourth chemotherapy cycle was significantly associated with relapse time (P = 0.044). The sensitivity was 70.0%, and the specificity was 76.9%. Moreover, in all relapsed patients, the group with the CA125 decrease ratio after the fourth chemotherapy cycle of more than 97.6% had a significantly better OS than any other group (P = 0.0019).

CONCLUSION: The CA125 decrease ratio of less than 97.6% after the fourth chemotherapy cycle can be a predictive factor for relapse within 12 months. Patients without a significant decrease in CA125 after four cycles of chemotherapy should have a more frequent follow-up and more active re-examination.