Pretreatment CA 15-3 levels do not predict disease-free survival in patients with advanced epithelial ovarian cancer

Aims. To evaluate the role of pretreatment CA 15-3 levels as a predictor of disease-free survival in patients with advanced epithelial ovarian cancer. Methods. A cohort of 65 patients with FIGO stage III or IV epithelial ovarian cancer was evaluated. Patients were treated either with primary cytoreductive surgery followed by adjuvant platinum-based chemotherapy or with neoadjuvant chemotherapy with interval debulking surgery. All patients had pretreatment CA 15-3 and CA 125 tumor marker determinations. The patients were divided into a group with elevated CA 15-3 and a group with normal levels. The two groups were compared with regard to clinical and survival measures. Results. The patients' median age was 65 years (range, 37-90); 34 (52%) were at stage III and 31 (48%) at stage IV. CA 15-3 was elevated (>30 units/mL) in 44 (68%) patients, with a median level of 39 units (range, 4-2282). CA 125 was elevated (>35 units/mL) in 61 (94%) patients, with a median level of 947 units (range, 4-30,642). CA 125 and CA 15-3 levels were not correlated (r = 0.015, P = 0.332). The median follow-up was 22 months (range, 3-120 months). Fifty-three (81%) patients had disease recurrence and 43 (66%) died. Survival analysis showed that patients with elevated and normal CA 15-3 levels had similar recurrence-free survival (P = 0.78) and overall survival (P = 0.55). Conclusions. Although elevated in the majority of patients with advanced epithelial ovarian cancer, CA 15-3 levels are not predictive of survival.