Comparison of survival outcomes after recurrence detected by cancer antigen 125 elevation versus imaging study in epithelial ovarian cancer

다국어 초록 (Multilingual Abstract)

Objective: The aim of this study was to compare survival outcomes in two groups of patients withrecurrent epithelial ovarian cancer (EOC) with initial recurrence detection by cancer antigen 125(CA-125) elevation or imaging, and underwent secondary cytoreductive surgery (SCS).
Methods: A retrospective review of the medical records was performed on 99 recurrent EOCpatients who underwent SCS at the Samsung Medical Center between January 2002 andDecember 2013. For follow-up after primary treatment, patients were routinely assessed byCA-125 levels every 3 months and computed tomography (CT) scan (or magnetic resonanceimaging [MRI]) every 6 months for first 3 years, and by CA-125 every 6 months and CT scan(or MRI) every 12 months thereafter.
Results: The first recurrence was initially identified by either CA-125 elevation (n=41, 41.4%)or by imaging study (n=58, 58.6%). None of the patients showed the symptoms as initialsign of recurrence. There were higher percentages of extra-pelvic recurrence (87.8%) andmultiple recurrences (78.0%) in the group diagnosed by CA-125 elevation. The proportion ofno residual disease after SCS was comparably lower in the CA-125 group (22.0% vs. 72.4%).
There were 19 cancer-associated deaths (19.2%) within a median follow-up period of 67months. The group diagnosed by imaging had better overall survival from initial diagnosis(OS1), overall survival after SCS (OS2), progression-free survival after the initial treatment(PFS1) and progression-free survival after SCS compared to those of the CA-125 group (PFS2).
Conclusion: EOC patients with recurrence initially detected by imaging study showed bettersurvival outcomes than patients diagnosed by CA-125 elevation.

참고문헌 (Reference)

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