Document Detail


Clinical use of serum CA-125 levels in patients undergoing radical cystectomy for transitional cell carcinoma of the bladder.
MedLine Citation:
PMID:  18555706     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: It has recently been reported that serum CA-125 levels may serve as a prognostic indicator of extravesical disease in patients with bladder cancer. This study evaluated the role of CA-125 as a prognostic marker in patients with transitional cell carcinoma of the bladder undergoing radical cystectomy and urinary diversion. METHODS: Ninety-two consecutive patients underwent planned radical cystectomy and urinary diversion with curative intent (2005-2006). Serum CA-125 levels were obtained in all patients and correlations were made to clinical and operative findings and pathological outcomes. Outcomes were evaluated with regard to normal vs. abnormal CA-125 values and with regard to absolute values of CA-125 levels. Results were also stratified by short-term recurrence rates. RESULTS: Mean CA-125 values varied significantly by pathological stage and by resectability. No patient (0/56) with organ-confined disease (<or= pT2N0) had an abnormal CA-125, and only 1 patient (1/75 = 1.3%) with <or= pT3N0 disease had an abnormal value. Conversely, 35% of patients with regionally-advanced disease (pT4 or N+) had an elevated CA-125, and all patients with unresectable disease (5/5) had an elevated value. In addition, patients with abnormal values of CA-125 (i.e., <35 U/ml) had a significantly higher upstaging rate compared to non-upstaged patients (18.8% vs. 3.5%, respectively; P = 0.0233). As well, patients with CA-125 levels <15 U/ml had a significantly higher upstaging rate compared with non-upstaged patients (53.1% vs. 15.8%, respectively; P = 0.0005). At a mean follow-up of 15 months (median = 14 months), patients with T2/T3N0 disease who recurred had a higher mean value than patients with pT2/T3 disease who did not recur (20.1 vs. 10.8 U/ml). CONCLUSIONS: Serum CA-125 levels may serve as a useful predictor of pathological outcomes in patients undergoing cystectomy for urothelial carcinoma of the bladder. Further studies will be carried out to determine the predictability of CA-125 on long-term recurrence and survival rates, and to evaluate the utility of CA-125 as a marker for disease response in patients with recurrent or advanced disease undergoing systemic therapy.
Authors:
Erik J Kouba; Aaron Lentz; Eric M Wallen; Raj S Pruthi
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Publication Detail:
Type:  Journal Article     Date:  2008-06-16
Journal Detail:
Title:  Urologic oncology     Volume:  27     ISSN:  1873-2496     ISO Abbreviation:  Urol. Oncol.     Publication Date:    2009 Sep-Oct
Date Detail:
Created Date:  2009-09-01     Completed Date:  2009-11-17     Revised Date:  2010-03-18    
Medline Journal Info:
Nlm Unique ID:  9805460     Medline TA:  Urol Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  486-90     Citation Subset:  IM    
Affiliation:
Division of Urologic Surgery and the Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
CA-125 Antigen / blood*
Carcinoma, Transitional Cell / blood*,  pathology,  surgery
Cystectomy
Female
Humans
Immunoassay
Male
Middle Aged
Neoplasm Recurrence, Local / blood,  pathology
Neoplasm Staging
Prognosis
Sensitivity and Specificity
Tumor Markers, Biological / blood*
Urinary Bladder Neoplasms / blood*,  pathology,  surgery
Chemical
Reg. No./Substance:
0/CA-125 Antigen; 0/Tumor Markers, Biological
Comments/Corrections
Comment In:
Urol Oncol. 2010 Mar-Apr;28(2):226   [PMID:  20056459 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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