Prognostic indicators for poor risk epithelial ovarian carcinoma

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Abstract
Background. The objective of this study was to identify factors that categorize patients with epithelial ovarian carcinoma into favorable and unfavorable prognostic groups at the time of initial treatment. Methods. Data were analyzed from 51 women who were treated at Yale University, had an evaluable CA 125 half-life (t 0.5), and were followed for disease recurrence for at least 2 years. Results. Grade, maximum level of CA 125, and histology did not provide useful prognostic information. Stage, residual disease, minimum CA 125, and CA 125 t 0.5 individually were predictive of persistent disease or recurrence within 3 years of diagnosis with sensitivities of 97, 70, 34, and 49%, respectively, and specificities of 33, 83, 100, and 83%, respectively. When these factors are combined, defining an unfavorable prognostic group as those patients having residual disease greater than 1 cm, CA 125 t 0.5 greater than 12 days, or minimum CA 125 never falling below 35 U/ml, sensitivity and specificity were 96 and 65%, respectively, at 1 year of follow-up and 91 and 75%, respectively, at 3 years of follow-up. Conclusions. In those patients in whom residual small volume disease after primary surgery indicates a good prognosis, minimum CA 125 and CA 125 t 0.5 during chemotherapy can further categorize patients into favorable and unfavorable prognostic groups.