Prognostic significance of CA 125 and TPS levels after 3 chemotherapy courses in ovarian cancer patients

Objective. To evaluate the prognostic significance of and predictive value for survival of CA 125 and TPS levels after three chemotherapy courses in o varian cancer patients. Methods. We analyzed in a prospective multicenter study the 1- and 2-year o verall survival (OS) in ovarian carcinoma patients. The prognostic signific ance of CA 125 and TPS levels above the discrimination value (25 kU/L and 1 00 Un, respectively) was examined by univariate and multivariate analyses. Results. Of the 213 cases included, 64 patients were staged as PICO I + II and 149 patients were staged as PICO III + IV. Tumor marker levels in stage I + II were not correlated with survival. However, stage UI and IV patient s with elevated levels of CA 125 or TPS after three chemotherapy courses ha d a worse 2-year OS (69% vs 26%, P < 0.0001 and 57% vs 20%, P < 0.0001, res pectively) than patients with normal levels of the markers. In univariate a nalysis the result of operation (staging laparatomy and partial debulking) and advanced FIGO stage (IV) were also adverse prognostic factors. Independ ent factors predictive of low 2-year OS by multivariate analysis were stagi ng laparotomy, TPS elevated, and CA 125 elevated, The only factors predicti ve of low 1-year OS were TPS elevated and staging laparotomy, Conclusions. Ovarian cancer patients with elevated CA 125 levels after thre e chemotherapy courses have a poor prognosis. Hoc-ever, the prognostic accu racy can be significantly increased by the parallel determination of serum TPS. (C) 2000 Academic Press.