Nadir CA-125 level is an independent prognostic factor in advanced epithelial ovarian cancer.

Background: The purpose of this study was to determine the independency of a nadir CA-125 level as a prognostic factor in patients with advanced epithelial ovarian cancer (EOC).

Methods: Among the 153 women with advanced EOC who had surgery in our hospital between January 2001 and June 2007, 121 women underwent retrospective chart review.

Results: Sixty-six patients (57.9%) had nadir CA-125 values < or =10 U/ml. The CA-125 levels at the time of diagnosis was associated with the nadir CA-125 (P = 0.018). The median progression-free survival (PFS) in patients with nadir CA-125 levels < or =10 and 10-35 U/ml was 32.4 and 16.8 months, respectively (P = 0.0001). A multivariate Cox hazard model revealed that the nadir CA-125 value and the residual tumor size > or =0.5 cm were independently associated with the PFS (P = 0.001 and 0.014). Within the subgroup who underwent primary debulking surgery, the significant association between the PFS and the nadir CA-125 value was preserved (P = 0.001).

Conclusions: The prognostic role of the nadir CA-125 is independent of residual tumor size in the patients with advanced EOC. However, it is still unclear whether maximal surgical effort can affect the nadir CA-125 levels.