Affiliations: [a] Laboratory of Pharmacology. Faculty of Pharmacy, University of Coimbra, 3000-141 Coimbra, Portugal | [b] Gynaecology Service, Coimbra University Hospital, 3000-141 Coimbra, Portugal | [c] Pathology Service. Coimbra University Hospital, 3000-141 Coimbra, Portugal
Correspondence:
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Corresponding author: Amílcar Falcão, PhD, Laboratory of Pharmacology, Faculty of Pharmacy, University of Coimbra, 3000-141 Coimbra, Portugal. Tel.: +351 239855089; Fax: +351 239855099; E-mail: acfalcao@ff.uc.pt.
Abstract: Purpose:The aim of the present work was to evaluate the usefulness of CA-125 normalized in time area under the curve (CA-125 AUC) to signalise epithelial ovarian cancer relapse. Patients and Methods:Data from a hundred and eleven patients were submitted to two different approaches based on CA-125 AUC increase values to predict patient relapse. In Criterion A total CA-125 AUC normalized in time value (AUCi) was compared with the immediately previous one (AUCi−1) using the formulae AUCi≥F∗AUCi−1 (several F values were tested) to find the appropriate close related increment associated to patient relapse. In Criterion B total CA-125 AUC normalised in time was calculated and several cut-off values were correlated with patient relapse prediction capacity. Results:In Criterion A the best accuracy was achieved with a factor (F) of 1.25 (increment of 25% from the previous status), while in Criterion B the best accuracies were achieved with cut-offs of 25, 50, 75 and 100 IU/mL. The mean lead time to relapse achieved with Criterion A was 181 days, while with Criterion B they were, respectively, 131, 111, 63 and 11 days. Conclusion:Based on our results we believe that conjugation and sequential application of both criteria in patient relapse detection should be highly advisable. CA-125 AUC rapid burst in asymptomatic patients should be firstly evaluated using Criterion A with a high accuracy (0.85) and with a substantial mean lead time to relapse (181 days). If a negative answer was obtained then Criterion B should performed to confirm the absence of relapse.
