SERUM HALF-LIFE OF CA-125 DURING EARLY CHEMOTHERAPY AS AN INDEPENDENTPROGNOSTIC VARIABLE FOR PATIENTS WITH ADVANCED EPITHELIAL OVARIAN-CANCER - RESULTS OF A MULTICENTRIC ITALIAN STUDY

This retrospective multicentric study assessed the prognostic value of the serum CA 125 assay and the common clinicopathological variables i n 225 patients with advanced epithelial ovarian cancer. All of these p atients had serum CA 125 greater than or equal to 35 U/ml before the f irst cycle of chemotherapy and had had serial antigen determinations d uring early chemotherapy, By univariate analysis pathological complete response rate was significantly related to stage, size of residual di sease after first surgery, serum CA 125 before the first cycle and bef ore the third cycle of chemotherapy, and serum CA 125 half-life. Multi ple logistic regression showed that residual disease (P = 0.002), seru m CA 125 half-life (P = 0.004), serum CA 125 before the third cycle (P = 0.004), and serum CA 125 before the first cycle (P = 0.03) retained a significant value in predicting second-look findings. By log-rank t est survival was significantly related to stage, residual disease, tum or grade, serum CA 125 before the third cycle, and serum CA 125 half-l ife. Cox proportional hazard model showed that residual disease (P = 0 .0001), serum CA 125 half-life (P = 0.007), and tumor grade (P = 0.01) retained a significant value in predicting survival. In conclusion, s erum CA 125 half-life during early chemotherapy was an independent pro gnostic factor for both the achievement of a pathological complete res ponse and the survival of patients with advanced epithelial ovarian ca ncer. (C) 1995 Academic Press, Inc.