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Prognostic Value of Serum CA19-9 and Perioperative CA-125 Levels in Ovarian Clear Cell Carcinoma
  1. Jun Zhu, MD*,,
  2. Long Jiang, MD,
  3. Hao Wen, MD*,,
  4. Rui Bi, MD, PhD§,
  5. Xiaohua Wu, MD, PhD*, and
  6. Xingzhu Ju, MD, PhD*,
  1. *Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center;
  2. Department of Oncology, Shanghai Medical College, Fudan University;
  3. Department of Anesthesia, Zhongshan Hospital, Fudan University; and
  4. §Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, PR China.
  1. Address correspondence and reprint requests to Xingzhu Ju, MD, PhD, Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, 270 Dong-an Road, Shanghai 200032, China. E-mail:


Background There are no effective biomarkers for surveillance in ovarian clear cell carcinoma (OCCC), and the value of carbohydrate antigen 125 (CA-125) is limited. We sought to determine the value of both carbohydrate antigen 19-9 (CA19-9) and CA-125 levels postoperatively on the prognosis for OCCC.

Methods A total of 130 patients with OCCC who were consecutively treated by cytoreduction at Fudan University Shanghai Cancer Center were reviewed retrospectively. Univariate log-rank analyses and Cox regression multivariate analyses were performed to identify predictors of recurrence-free (RFS) and overall survival (OS) rates.

Results The survival in patients with postoperative normalization of CA-125 was significantly better than those with decreased but still elevated CA-125 (5-year RFS rates, 57.9% vs 45.2%, P = 0.046; 5-year OS rates, 81.4% vs 54.4%, P = 0.016), or those with increased CA-125 (5-year RFS rates, 57.9% vs 29.2%, P = 0.001; 5-year OS rates, 81.4% vs 33.6%, P < 0.001). An elevated level of postoperative CA-125 level was an independent risk factor for recurrence and survival [RFS: hazard ratio (HR), 2.2; P = 0.033; OS: HR, 4.3; P = 0.019]. Elevated postoperative CA19-9 was an independent risk factor for both RFS and OS in patients with normal postoperative CA-125 levels (RFS: HR, 5.0; P = 0.005; OS: HR, 1.1; P = 0.035).

Conclusions Combining postoperative CA19-9 and CA-125 appeared to be of great clinical value for prognosis in patients with OCCC after initial debulking.

  • OCCC
  • CA-125
  • CA19-9
  • Prognosis

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  • The authors declare no conflicts of interest.

  • Author contributions: conception and design: J.Z., H.W., X.J., and X.W.; collection and assembly of data: J.Z. and H.W.; data analysis and interpretation: J.Z. and L.J.; pathological slides reviewing: J.Z., Y.W., and R.B.; manuscript writing: J.Z., H.W., and X.J.; and final approval of manuscript: J.Z., H.W., X.J., R.B., and X.W.

  • Jun Zhu and Long Jiang contributed equally to this work.

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