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

Christoph Wohlmuth; Vladimir Djedovic; Susanne K Kjaer; Allan Jensen; Rosalind Glasspool; Patricia Roxburgh; Anna DeFazio; Sharon E Johnatty; Penelope M Webb; Francesmary Modugno; Diether Lambrechts; Joellen M Schildkraut; Andrew Berchuck; Liv Cecilie Vestrheim Thomsen; Line Bjorge; Estrid Høgdall; Claus K Høgdall; Ellen L Goode; Stacey J Winham; Keitaro Matsuo; Beth Y Karlan; Jenny Lester; Marc T Goodman; Pamela J Thompson; Tanja Pejovic; Marjorie J Riggan; Katherine Lajkosz; Alicia Tone; Taymaa May

doi:10.3390/cancers14081954

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

Christoph Wohlmuth
, Vladimir Djedovic
, Susanne K Kjaer
, Allan Jensen
, Rosalind Glasspool
, Patricia Roxburgh
, Anna DeFazio
, Sharon E Johnatty
, Penelope M Webb
, Francesmary Modugno
, Diether Lambrechts
, Joellen M Schildkraut
, Andrew Berchuck
, Liv Cecilie Vestrheim Thomsen
, Line Bjorge
, Estrid Høgdall
, Claus K Høgdall
, Ellen L Goode
, Stacey J Winham
, Keitaro Matsuo

Beth Y Karlan, Jenny Lester, Marc T Goodman, Pamela J Thompson, Tanja Pejovic, Marjorie J Riggan, Katherine Lajkosz, Alicia Tone, Taymaa May

Department of Pathology

11 Citations (Scopus)

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.

Original language	English
Article number	1954
Journal	Cancers
Volume	14
Issue number	8
ISSN	2072-6694
DOIs	https://doi.org/10.3390/cancers14081954
Publication status	Published - 13 Apr 2022

Keywords

CA-125
low-grade serous cancer
ovarian cancer
survival

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10.3390/cancers14081954

Cite this

Wohlmuth, C., Djedovic, V., Kjaer, S. K., Jensen, A., Glasspool, R., Roxburgh, P., DeFazio, A., Johnatty, S. E., Webb, P. M., Modugno, F., Lambrechts, D., Schildkraut, J. M., Berchuck, A., Thomsen, L. C. V., Bjorge, L., Høgdall, E., Høgdall, C. K., Goode, E. L., Winham, S. J., ... May, T. (2022). CA-125 Levels Are Predictive of Survival in Low-Grade Serous Ovarian Cancer-A Multicenter Analysis. Cancers, 14(8), Article 1954. https://doi.org/10.3390/cancers14081954

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, Høgdall, E , Høgdall, 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 2022, 'CA-125 Levels Are Predictive of Survival in Low-Grade Serous Ovarian Cancer-A Multicenter Analysis', Cancers, vol. 14, no. 8, 1954. https://doi.org/10.3390/cancers14081954

@article{727b7bc2ce3c49e6a60d77da21a1f22a,

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

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",

author = "Christoph Wohlmuth and Vladimir Djedovic and Kjaer, \{Susanne K\} and Allan Jensen and Rosalind Glasspool and Patricia Roxburgh and Anna DeFazio and Johnatty, \{Sharon E\} and Webb, \{Penelope M\} and Francesmary Modugno and Diether Lambrechts and Schildkraut, \{Joellen M\} and Andrew Berchuck and Thomsen, \{Liv Cecilie Vestrheim\} and Line Bjorge and Estrid H{\o}gdall and H{\o}gdall, \{Claus K\} and Goode, \{Ellen L\} and Winham, \{Stacey J\} and Keitaro Matsuo and Karlan, \{Beth Y\} and Jenny Lester and Goodman, \{Marc T\} and Thompson, \{Pamela J\} and Tanja Pejovic and Riggan, \{Marjorie J\} and Katherine Lajkosz and Alicia Tone and Taymaa May",

year = "2022",

month = apr,

day = "13",

doi = "10.3390/cancers14081954",

language = "English",

volume = "14",

journal = "Cancers",

issn = "2072-6694",

publisher = "M D P I AG",

number = "8",

}

TY - JOUR

T1 - CA-125 Levels Are Predictive of Survival in Low-Grade Serous Ovarian Cancer-A Multicenter Analysis

AU - Wohlmuth, Christoph

AU - Djedovic, Vladimir

AU - Kjaer, Susanne K

AU - Jensen, Allan

AU - Glasspool, Rosalind

AU - Roxburgh, Patricia

AU - DeFazio, Anna

AU - Johnatty, Sharon E

AU - Webb, Penelope M

AU - Modugno, Francesmary

AU - Lambrechts, Diether

AU - Schildkraut, Joellen M

AU - Berchuck, Andrew

AU - Thomsen, Liv Cecilie Vestrheim

AU - Bjorge, Line

AU - Høgdall, Estrid

AU - Høgdall, Claus K

AU - Goode, Ellen L

AU - Winham, Stacey J

AU - Matsuo, Keitaro

AU - Karlan, Beth Y

AU - Lester, Jenny

AU - Goodman, Marc T

AU - Thompson, Pamela J

AU - Pejovic, Tanja

AU - Riggan, Marjorie J

AU - Lajkosz, Katherine

AU - Tone, Alicia

AU - May, Taymaa

PY - 2022/4/13

Y1 - 2022/4/13

N2 - 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.

AB - 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.

KW - CA-125

KW - low-grade serous cancer

KW - ovarian cancer

KW - survival

UR - https://www.scopus.com/pages/publications/85128234638

U2 - 10.3390/cancers14081954

DO - 10.3390/cancers14081954

M3 - Journal article

C2 - 35454861

SN - 2072-6694

VL - 14

JO - Cancers

JF - Cancers

IS - 8

M1 - 1954

ER -

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

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Keywords

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