-Original-

Serum CA 125 Level after Neoadjuvant Chemotherapy is Predictive of Prognosis and Debulking Surgery Outcomes in Advanced Epithelial Ovarian Cancer

Tomohiko Matsuhashi^1,2, Toshiyuki Takeshita³, Akihito Yamamoto³, Rieko Kawase³, Takashi Yamada¹, Keisuke Kurose³, Daisuke Doi⁴, Katsuyuki Konnai², Ryo Onose² and Hisamori Kato²

¹Department of Obstetrics and Gynecology, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
²Department of Gynecology, Kanagawa Cancer Center, Kanagawa, Japan
³Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan
⁴Department of Obstetrics and Gynecology, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan

Recently, neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS) has been recommended for selected patients with International Federation of Gynecology and Obstetrics (FIGO) stage III or IV disease and bulky tumors. The aim of this study was to evaluate associations between post-NACT serum CA 125 levels, surgical outcomes, and clinical outcomes in patients with advanced epithelial ovarian cancer. We retrospectively analyzed 107 patients with FIGO stage III or IV ovarian cancer who were treated with NACT-IDS at the Gynecology Department of Kanagawa Cancer Center between January 2001 and December 2012. Serum CA 125 levels after NACT were significantly lower in the complete/optimal IDS group compared to the suboptimal IDS group (mean±standard deviation: 48.1±27.6 vs. 346.5±295.2 U/mL, p<0.01). Patients with low preoperative CA 125 levels (<35 U/mL) had a higher probability of optimal IDS (78.1±41.9% vs. 33.3±19.2%, p<0.01) and longer progression-free survival (mean±standard deviation: 30.4±14.3 months vs. 21.3±7.3 months, p<0.05) than patients with high CA 125 levels (>100 U/mL). Patients with low CA 125 levels (<35 U/mL) had a higher probability of complete/optimal IDS and longer progression-free survival compared to patients with high CA 125 levels (>100 U/mL).

J Nippon Med Sch 2017; 84: 170-176

Keywords
cancer antigen 125, interval debulking surgery, neoadjuvant chemotherapy, ovarian cancer, prognosis

Correspondence to
Tomohiko Matsuhashi, MD, Department of Obstetrics and Gynecology, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba 270-1694, Japan
t-matsuhashi@nms.ac.jp

Received, March 7, 2017
Accepted, June 7, 2017