Serum CA 125 levels and survival in advanced ovarian cancer

We made a retrospective analysis of 85 patients with elevated serum CA 125 after surgery for ovarian cancer. Absolute CA 125 serum levels were a poor guide to prognosis. However, the ratio between the serum CA 125 after the first, second, or third course of treatment and the postoperative value was an excellent guide to prognosis. These were also independent and stable in the Cox Regression analysis.     

Prognostic value of nuclear DNA quantification and cyclin A expression in epithelial ovarian carcinoma

OBJECTIVE: To investigate the correlation of DNA ploidy, S-phase fraction (SPF) and the expression of cyclin A to the clinical prognostic factors in patients with epithelial ovarian cancer. STUDY DESIGN: A prospective analysis was performed on 46 ovarian tumor patients. The DNA ploidy and SPF were determined by flow cytometry and the expression of cyclin A was measured by immunohistochemical staining. RESULTS: Compared with benign and borderline tumors, the malignant tumors expressed higher levels of cyclin A (P=0.007), more aneuploid cells (P=0.018) and higher SPF (P=0.015). With regard to DNA ploidy and the clinical prognostic factors, aneuploid cells increased with tumor grade (P=0.011), the disease stage (P=0.009) and residual volume (P=0.001). When residual tumor was more than 2 cm, the expression of cyclin A was increased (P=0.043). Three-year survival was low for patients with tumors expressing cyclin A in over 10% of cells (P=0.003). CONCLUSIONS: The data suggest that the assessment of the DNA ploidy, SPF and the expression of cyclin A may provide important information for predicting the prognosis of epithelial ovarian cancer.     

The survival detriment of venous thromboembolism with epithelial ovarian cancer

Objective

The aim of this study is to evaluate the effect of venous thromboembolism (VTE) chronology with respect to surgery on survival with epithelial ovarian cancer (EOC).

Methods

An IRB approved, retrospective review was performed of patients treated for Stage I–IV EOC from 1996 to 2011. Cox proportional hazards model was used to assess associations between VTE and the primary outcomes of progression free survival (PFS) and overall survival (OS). SAS 9.3 was used for statistical analyses.

Results

586 patients met study criteria. Median age was 63 years (range, 17–94); median BMI was 27.1 kg/m² (range, 13.7–67.0). Most tumors were high grade serous (68.3%) and advanced stage (III/IV, 75.4%). 3.7% had a preoperative VTE; 13.2% had a postoperative VTE. Upon multivariate analysis adjusting for age, stage, histology, performance status, and residual disease, preoperative VTE was predictive of OS (HR 3.1, 95% CI: 1.6–6.1, p = 0.001) but not PFS (p = 0.55). Postoperative VTE was associated with shorter PFS (HR 1.45, 95% CI: 1.04–2.02, p = 0.03) and OS (HR 1.8, 95% CI: 1.3–2.6, p = 0.001). When VTE timing was modeled, preoperative VTE (HR 3.5, 95% CI: 1.8–6.9, p < 0.001) and postoperative VTE after primary therapy (HR 2.3, 95% CI: 1.4–3.6, p = 0.001) were predictive of OS.

Conclusion

Preoperative and postoperative VTE appear to have a detrimental effect on OS with EOC. When modeled as a binary variable, postoperative VTE attenuated PFS; however, when VTE timing was modeled, postoperative VTE was not associated with PFS. It is unclear whether VTE is an inherent poor prognostic marker or if improved VTE prophylaxis and treatment may enable similar survival to patients without these events.     

Best predictors of survival outcome after tertiary cytoreduction in patients with recurrent platinum-sensitive epithelial ovarian cancer

Objective

To evaluate the efficacy of tertiary cytoreduction (TCR) on survival and to determine prognostic factors which may influence surgical and survival outcome.

Study design

Twenty-three consecutive patients who had recurrent platinum-sensitive epithelial ovarian cancer and underwent TCR between January 1999 and January 2011 were evaluated. Factors which impact on TCR outcome and survival were determined by statistical analysis.

Results

TCR was optimal (< 1 cm residual tumor) in 15 of the 23 patients (65.2%) and suboptimal in 8 patients (34.8%). None of the clinicopathologic factors was associated with TCR outcome. On the contrary, TCR outcome (optimal vs suboptimal) was independently associated with survival in univariate analysis (P = 0.018).

Conclusion

There is not a good predictor of TCR outcome but TCR seems to be beneficial for patients in whom optimal surgery can be achieved. Therefore, preoperative assessment of patients and weighing the potential survival benefit against potential surgical risks are very important for patient selection.     

卵巢癌中p27kip1和Cyclin D1的表达与预后因素的相关性研究

目的　探讨 p2 7kip1、CyclinD1在卵巢癌发生、发展方面的意义。 方法　应用免疫组化染色及半定量分析的方法 ,检测 5 0例卵巢癌、19例卵巢良性上皮肿瘤、13例正常卵巢组织中的p2 7kip1、CyclinD1表达 ,及它们与上皮组织的良恶性、病理组织分级、临床分期的相关性。结果　正常卵巢组和卵巢良性肿瘤组间 ,p2 7、CyclinD1表达无明显差异 ;p2 7在正常卵巢组织和卵巢良性上皮肿瘤中高表达 ,在卵巢癌中表达降低 (P <0 0 5 ) ,且随着肿瘤分级、分期增高 (恶性程度增高 ) ,阳性表达率逐渐下降 ;而CyclinD1的表达则相反 ;两者在肿瘤中的表达呈负相关。结论　p2 7kip1表达下降、CyclinD1过表达可能在卵巢癌的发生发展中起重要作用 ,检测 p2 7kip1、CyclinD1在卵巢癌中的表达可预测该肿瘤生物学行为特征 ,可以作为预后指标     

The effect of symptom duration in epithelial ovarian cancer on prognostic factors

Purpose  To assess the association between duration of symptoms and main prognostic factors of invasive epithelial ovarian cancer (EOC). Methods  The data of all histologically confirmed EOC patients diagnosed in Israel during the period 1994–1999 (n = 1,005) were retrieved from discharge summaries and admission records. Of the 371 (36.9%) patients with known presenting symptoms, the durations of 187 (50.4%) were recorded. Results  The most common presenting symptoms were abdominal pain (65.2%). The percentage of patients with three or more symptoms increased significantly with stage (P = 0.001). No statistically significant association between duration of symptoms and prognostic factors was found. Conclusion  Our findings did not show an association between duration of symptoms and prognostic factors in EOC patients and may indicate that prognosis is not a function of delay in diagnosis.     

Survival of Californian women with epithelial ovarian cancer, 1994-1996: a population-based study

OBJECTIVE: The objective was to identify demographic, clinical, and provider characteristics that might influence cancer survival in a cohort of Northern California women using a population-based cancer registry. METHODS: We used California Cancer Registry data to evaluate survival in 1051 Northern California women who were diagnosed with epithelial ovarian cancer between 1994 and 1996 and underwent a surgical procedure for their cancer. Chemotherapy data from the cancer registry were supplemented with a physician survey and medical record review. Database linkages with census and hospital discharge data provided socioeconomic and comorbidity measures. Kaplan-Meier method was used to generate survival curves and multivariate Cox proportional hazard models were used to evaluate the effect of different factors on survival. RESULTS: Crude 5-year survival was 82, 57, 28, and 10% for women with FIGO stage IC, II, III, and IV disease, respectively. Adverse survival was most strongly influenced by advanced stages III and IV with a hazards ratio ranging from 8 to 11.8 compared to stage IC disease. Multivariate analysis also identified other adverse factors including high grade and other adverse histologies, age over 45, and rural location. Chemotherapy decreased the risk of death by 50% if the patient had advanced-stage disease. Medical comorbidity increased the risk of death by 40%. Survival was not influenced by race/ethnicity, socioeconomic status, physician specialty, or hospital characteristics. CONCLUSION: Advanced age remains an adverse prognostic factor even after adjustment for treatment and comorbidity factors. These results also suggest that there may be important regional differences in ovarian cancer survival.     

High GMFG expression correlates with poor prognosis and promotes cell migration and invasion in epithelial ovarian cancer

Objective

The aim of this study was to characterize the clinical significance of GMFG, a novel ADF/cofilin superfamily protein, and investigate its role in cell migration and invasion in epithelial ovarian cancer (EOC).

Methods

The expression of GMFG in EOC tissues and ovarian cancer cell lines was evaluated by immunohistochemistry and immunoblotting respectively. The data were statistically analyzed for the associations of GMFG expression with clinicopathologic parameters and survival. In vitro cell migration and invasion assays were performed to determine the role of GMFG in cell migratory behaviors. The effect of GMFG on reorganization of actin cytoskeleton was investigated by immunostaining.

Results

GMFG was overexpressed in EOC. Up-regulated GMFG expression was closely correlated with advanced FIGO stage and chemoresistance of the disease. EOC patients with higher GMFG expression showed poorer progression-free survival (PFS) and overall survival (OS). In vitro cellular assays revealed that GMFG promoted cell migration and invasion. GMFG expression altered actin cytoskeleton organization probably by interacting with the Arp2/3 complex.

Conclusion

GMFG expression independently predicts poorer prognosis in patients with EOC. Ectopic overexpression of GMFG contributes to the malignant biological behavior of ovarian cancer cells.     

Prognostic factors for early-stage epithelial ovarian cancer, treated with adjuvant carboplatin/paclitaxel chemotherapy: A single institution experience

Objective

Early-stage epithelial ovarian cancer represents a prognostically heterogenous group. We studied prognostic factors in patients treated with adjuvant paclitaxel/carboplatin chemotherapy.

Methods

Data was extracted from 147 patients with FIGO stage IA/IB, grade 2/3 or stage IC/IIA (any grade) who underwent primary surgery followed by paclitaxel/carboplatin chemotherapy.

Results

Median follow-up was 88 months. Ten-year relapse-free (RFS) and disease-specific survival (DSS) were: 81% (95% confidence interval [CI]: 73–89) and 81% (95% CI: 73–89). On multivariate analysis, non serous histology was associated with reduced risk for RFS (0.294, 95% CI: 0.112–0.577, p = 0.001) and DSS (0.194, 95% CI: 0.075–0.504, p = 0.001), while high-risk category (stage IC/IIA and grade 2/3) with increased risk for RFS (3.989, 95% CI: 1.189–13.389, p = 0.009) and DSS (3.989, 95% CI: 1.064–16.386, p = 0.038). The combination of histology and grade identified 3 groups with distinctly different 10-year RFS and DSS rates (p < 0.001): grade 1 (100% and 100%), non-serous grade 2/3 (83% and 86%) and serous grade 2/3 (60% and 60%).

Conclusions

Serous histology is an adverse prognostic factor in early-stage ovarian cancer treated with adjuvant paclitaxel/carboplatin. Risk stratification according to histology and grade is a useful discriminator of prognosis and can be used in the design of future studies.     

Improved 5-year disease-free survival for FIGO stage I epithelial ovarian cancer patients without tumor rupture during surgery

Objective.

To investigate the impact of perioperative capsule rupture on disease-free survival (DFS) and cancer-specific survival (CSS) in patients with FIGO stage I epithelial ovarian cancer (EOC I).

Methods.

This prospective population-based study enrolled all 279 patients with EOC I diagnosed in Norway between 2002 and 2004. All patients underwent primary surgery. The data were collected from notification reports to the Norwegian Cancer Registry and included medical, surgical and histopathological records. Kaplan-Meier plots were used to show differences in DFS and CSS. Cox regression analyses were used to show the effect of prognostic factors on survival, expressed as hazard ratios (HRs).

Results.

Significantly more patients in the capsule rupture group (Cr group) had clear cell tumors (28%) than in the FIGO stage IA and IB (AB group: 14%) groups, and the FIGO stage IC (C group: 17%; p < 0.05) group. Despite adjuvant chemotherapy (AC), these patients had a poor 5-year DFS, 94% in the non-AC group and 81% in the AC group (p < 0.01).After five years of follow-up, there was a lower DFS among patients in the Cr group (79%) and the C group (81%), compared with patients in the AB group (91%; p < 0.05). Independent prognostic factors at the time of diagnosis were grade, histological type, ascites, adhesions, performance status, CA125 and DNA ploidy.After correcting for the four most important prognostic factors (grade, histological type, ascites, and DNA ploidy), the HR for recurrence was 4.0 (95% CI 1.3-12.7; p < 0.05) for the Cr group and 1.8 (95% CI 0.5-6.1; p = 0.3) for the C group, compared with the AB group.

Conclusions.

Improvement was observed in the 5-year DFS for EOC I patients without tumor rupture during surgery compared with those with tumor rupture. Since AC did not improve the long-term DFS and CSS rates, it is of utmost importance that surgeons avoid tumor rupture during surgery.     

Expression of cyclooxygenase-2 in advanced stage ovarian serous carcinoma: correlation with tumor cell proliferation, apoptosis, angiogenesis, and survival

OBJECTIVE: Cyclo-oxygenase-2 seems to be involved at various steps in the processes of tumor progression. The objective of this study was to examine the relationship between cyclo-oxygenase-2 expression and tumor proliferation, apoptosis and angiogenesis in patients with advanced stage high-grade ovarian carcinoma. STUDY DESIGN: Specimens from 118 patients with high-grade and advanced stage (III, IV) serous ovarian carcinoma were evaluated by immunohistochemistry for cyclo-oxygenase-2, Ki-67, vascular endothelial growth factor, and bcl-2 expression. Tumor microvessel density was assessed with CD34 immunostaining. We investigated the relationships between cyclo-oxygenase-2 expression and clinicopathologic characteristics, tumor angiogenesis (tumor microvessel density and vascular endothelial growth factor expression), and tumor proliferation and apoptosis. The effect of cyclooxygenase-2 expression on patient survival was determined. RESULTS: There was a significant positive correlation between cyclo-oxygenase-2 expression in tumor cells and markers of tumor proliferation and angiogenesis. In univariate survival analysis, high cyclo-oxygenase-2 and high Ki-67 expression showed a significant impact of on patient survival (P < .001). In multivariate regression analysis, only Ki-67 expression retained its significance as an independent poor prognostic factor (death hazard ratio, 2.0; 95% CI, 1.2-3.3; P < .001). CONCLUSION: Expression of cyclo-oxygenase-2 correlates with tumor proliferation and tumor angiogenesis but not with apoptotic markers (bcl-2 expression) in high-grade, advanced-stage serous ovarian carcinoma.     

Trends in therapy and survival of advanced stage epithelial ovarian cancer patients in the Netherlands

Objective

The aim of this study was to describe trends in survival and therapy in advanced stage epithelial ovarian cancer (EOC) in the Netherlands and to determine if changes in therapy affected survival.

Methods

All EOC patients diagnosed in the Netherlands during 1989-2009 were selected from the Netherlands Cancer Registry. Differences in treatment over time were tested by the Cochran-Armitage trend test. Multivariable relative survival analyses were performed to test whether changes in treatment are associated with survival.

Results

23,399 EOC patients were diagnosed, of whom 15,892 (67.9%) in advanced stage (stage ≥ 2b). In advanced stage patients, the proportion receiving (neo-)adjuvant chemotherapy and optimal debulking (residuals < 1 cm) increased over time in all age groups. In elderly patients (≥ 75 years) a stable proportion (approximately 28%) did not receive any treatment. Five-year relative survival in advanced stage patients increased from 18% in 1989-1993 to 28% in 2004-2009. In the multivariable model survival improved over time (relative excess risk (RER) of 2004-2009 was 0.71, 95% CI 0.67-0.75 compared to 1989-1993). This RER attenuated to 0.85 (95% CI 0.80-0.90) and 0.91 (95% CI 0.83-0.99) with inclusion of treatment variables in the model (surgery with chemotherapy or optimal surgery with chemotherapy, respectively). This suggests that the improvement was mainly, although not entirely, caused by changes in treatment.

Conclusion

Treatment in advanced stage EOC patients in the Netherlands improved over the last two decades; more patients received (neo)adjuvant chemotherapy and underwent optimal debulking surgery. Changes in treatment led to partial improvement of survival in EOC patients.     

雌二醇对BG-1卵巢癌细胞增殖及侵袭的影响

目的:探讨雌二醇(E2)对卵巢癌细胞BG-1增殖、侵袭的影响及作用机制。方法:MTT法检测10-9~10-5mol/L E2作用于BG-1细胞72h后的细胞增殖率的变化,并筛选最适作用浓度。将BG-1分为4组:E2组、E2+ICI(ICI182,780 ER阻断剂)组、E2+PPT(特异性ERα激动剂)组和E2+DPN(特异性ERβ激动剂)组。MTT法检测不同药物作用72h后的细胞增殖率;RT-PCR、Western blot法分别检测药物作用6、24h和48h后各组细胞中cyclin(细胞周期素)D1和p21表达水平;ELISA检测10-9~10-5mol/L E2作用后,BG-1细胞中MMP-9水平的变化;Transwell侵袭实验检测E2及ER调节剂作用后BG-1细胞的侵袭力变化。结果:10-9~10-5mol/L E2作用于BG-1细胞72h后,细胞增殖率均高于对照组(P0.05),并且E2浓度为10-7mol/L时BG-1细胞的增殖率最高。不同药物作用后,E2+PPT组的细胞增殖率显著高于E2组(P0.05),E2+ICI组的细胞增殖率显著低于E2组(P0.05),而E2+DPN组细胞增殖率无显著变化(P0.05)。与E2组相比,E2+ICI组中cyclin D1表达明显降低,p21表达显著升高(P0.05);E2+PPT组中cyclin D1与p21的表达水平与E2+ICI组大致相反(P0.05);E2+DPN组中cyclin D1和p21的表达均无明显变化(P0.05)。10-9~10-5mol/L E2均可促进MMP-9分泌(P0.05),其中10-8mol/L E2作用3h后MMP-9分泌最多。E2组的侵袭力显著高于空白对照组,而E2+ICI组的侵袭力显著低于空白对照组(P0.05)。结论:E2通过ERα信号通路促进BG-1细胞增殖;E2还能促进MMP-9分泌,增强BG-1细胞的侵袭力。     

Peritoneal VEGF burden as a predictor of cytoreductive surgery outcome in women with epithelial ovarian cancer

Objective

To determine whether peripheral plasma concentration, peritoneal fluid concentration, and/or peritoneal vascular endothelial growth factor (VEGF) burden can predict the possibility of optimal cytoreduction in women with epithelial ovarian carcinoma (EOC); and if so, to determine cutoff values below which optimal cytoreduction is likely to occur.

Methods

We measured plasma VEGF concentration, peritoneal VEGF concentration, and VEGF burden in 46 women undergoing cytoreductive surgery. Univariate analysis, bivariate analysis, correlation tests, and stepwise regression were performed with cytoreduction as the outcome.

Results

The VEGF burden best predicted the outcome. The area under the curve was 0.84 and the log-transformed cutoff value was 15.52 log pg. Overall, the chance of optimal cytoreduction was 11 times greater when the VEGF burden was less than 15.52 log pg. For women with advanced disease, the chance was 6 times greater below this value.

Conclusion

The VEGF burden may quantify tumor activity, and it could be used when selecting patients likely to benefit from induction chemotherapy before undergoing cytoreductive surgery.     

卵泡刺激素介导卵巢上皮性癌细胞增殖的初步研究

目的 探讨卵泡刺激素(FSH)促进卵巢上皮性癌细胞增殖的作用途径,从分子水平上了解卵巢癌的发病机理。方法 卵巢上皮癌细胞系OVCAR3转染FSH受体表达质粒,获得FSH刺激敏感的细胞系OVCAR3-FSHR。以FSH刺激细胞,或与蛋白激酶c(PKC)的激活剂十四烷酰佛波醇乙酯(TPA)和抑制剂他莫西芬(TAM)共同刺激细胞,以四甲基偶氮唑蓝法检测细胞的增殖情况,逆转录-聚合酶链反应技术检测细胞PKC各亚型的mRNA表达;以蛋白印迹法观察PKCα及磷酸化PKCα的表达水平。结果 FSH可刺激OVCAR3-FSHR细胞增殖1．9倍。FSH刺激后,PKCα的表达水平和活性分别增高1．5倍和1．9倍。TPA、TAM均能抑制FSH刺激OVCAR3-FSHR细胞增殖的60％及47％,TPA或TAM与FSH共同刺激PKCα表达较FSH单纯刺激者明显降低。结论 FSH通过PKC的途径,可刺激卵巢上皮癌细胞增殖,在卵巢上皮癌的发展中起一定的作用。     

Improved survival in non-Ashkenazi Jewish ovarian cancer patients with BRCA1 and BRCA2 gene mutations

Objectives

Previous studies report a survival advantage in ovarian cancer patients with Ashkenazi Jewish (AJ) breast cancer gene (BRCA) founder mutations. The purpose of this study was to determine if this association exists in patients with non-Ashkenazi Jewish (non-AJ) BRCA mutations. We also sought to account for “survival bias” by minimizing lead time that may exist between diagnosis and genetic testing.

Methods

Patients with stage III/IV ovarian cancer and a non-AJ BRCA mutation, seen between January 1996 and July 2007, were identified from eight institutions. Patients with sporadic ovarian cancer were compared to similar cases, matched by age, stage, year of diagnosis, and vital status at time interval to BRCA testing. Progression-free (PFS) and overall survival (OS) were calculated by the Kaplan-Meier method. Multivariate Cox proportional hazards models were calculated for variables of interest. Fisher's exact test and chi-square were also used for analysis.

Results

Ninety-five advanced stage ovarian cancer patients with non-AJ BRCA mutations and 183 sporadic controls were analyzed. Compared to sporadic ovarian cancer patients, non-AJ BRCA patients had longer PFS (27.9 months vs. 17.9 months, HR 0.61 [95% CI 0.43-0.86]) and OS (101.7 months vs. 54.3 months, HR 0.43 [95% CI 0.27-0.68]). BRCA status was an independent predictor of PFS and OS.

Conclusions

This multicenter study demonstrates a significant survival advantage in advanced stage ovarian cancer patients with non-AJ BRCA mutations, confirming the previous studies in the Jewish population. This improved survival was evident when accounting for the “survival bias” that coincides with genetic testing.     

Production of various marker substances in human ovarian cancer cell lines of epithelial origin

Summary Some characteristics of cell biology and the production of various tumor markers were examined using 8 human ovarian cancer cell lines of epithelial origin. Structural abnormalities of chromosomes 1, 3, and 6 were relatively common karyotypic changes among the cell lines. Cytoplasmic estradiol or progesterone receptor was not detected in any of the cell lines. A significant heterogeneity of the production of various tumor markers (ferritin, tissue peptide antigen, carcinoembryonic antigen, carbohydrate antigens 125, and 19-9) was noted among the cell lines grown in culture medium supplemented with serum. Three of the 8 cell lines were adapted to proliferate in completely synthetic serum-free culture medium. In addition to marker substances described above, small amounts of progesterone or human chorionic gonadotropin were produced in 2 of the 3 cell lines grown in serum-free culture medium. These results indicate that various marker substances including tumor markers are not produced consistently by human ovarian cancer cells of epithelial origin.     

Tumor markers in ovarian carcinoma.

This review analyzes in 2 ways the prognostic value of markers found in ovarian carcinomas before chemotherapy. It is known that neoangiogenesis, cyclooxygenase activity, and host responsiveness to chemotherapy can be evaluated by means of specific molecules recognized as tumor markers. However, host response as well as tumor histotype, grade of differentiation, clinical characteristics, and histopathologic characteristics must also be taken into account when selecting a treatment. Analysis must therefore focus on the molecular basis of aggressive disease, on tumor peculiarity, on the efficacy of chemotherapy, and on the host's response to the tumor. Although treatment may be more aggressive in patients with unfavorable prognostic elements, it may be modulated according to the molecular and cellular biology of the tumor and the host's response. When the tumor's molecular characterization contributes to the choice of treatment, prognostic markers may turn into predictive markers.     

A retrospective study of preoperative CA 125 levels in 82 patients with ovarian cancer

Introduction. The aim of our study was to investigate preoperative serum CA 125 as a prognostic factor in patients with ovarian carcinoma.Methods. A retrospective analysis was conducted on 82 patients with ovarian carcinoma treated at our Unit between 1998 and 2000 who had a serum CA 125, evaluated by a commercially available radioimmunoassay, prior to cytoreductive surgery. We looked for an association between preoperative CA 125 and known prognostic factors of ovarian cancer. We compared outcomes of patients with preoperative CA 125 at or below to 500 U/ml with outcomes of patients with preoperative CA 125 above 500 U/ml.Results. A significant (p<0.002) correlation between stage and CA 125 serum levels was found as 16 out of 18 stage I–II patients (89%) had CA 125 level 500 U/ml and 36 out of 64 stage III–IV patients (56%) had CA 125 level >500 U/ml. Among stage III and IV patients there was nonstatistically significant relation between serum CA 125 and histologic grade (G1+G2 vs. G3) and residual disease (<1 cm vs. >1 cm) after primary cytoreductive surgery. Preoperative serum CA-125 level did not predict either recurrences or disease free interval.Conclusion. Preoperative CA 125 correlated well with FIGO stage but not with age, grade, residual disease after primary surgery, relapse and disease free interval.