Clinical use of serum CA-125 levels in patients undergoing radical cystectomy for transitional cell carcinoma of the bladder

• Published in: Urologic oncology 2009-09, Vol.27 (5), p.486-490
• Main Authors: Kouba, Erik J., M.D, Lentz, Aaron, M.D, Wallen, Eric M., M.D, Pruthi, Raj S., M.D
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Biomarkers; Biomarkers, Tumor - blood; Bladder cancer; CA-125; CA-125 Antigen - blood; Carcinoma, Transitional Cell - blood; Carcinoma, Transitional Cell - pathology; Carcinoma, Transitional Cell - surgery; Cystectomy; Female; Humans; Immunoassay; Male; Medical sciences; Middle Aged; Neoplasm Recurrence, Local - blood; Neoplasm Recurrence, Local - pathology; Neoplasm Staging; Nephrology. Urinary tract diseases; Prognosis; Sensitivity and Specificity; Staging; Tumors; Tumors of the urinary system; Urinary Bladder Neoplasms - blood; Urinary Bladder Neoplasms - pathology; Urinary Bladder Neoplasms - surgery; Urinary tract. Prostate gland; Urology
• ISSN: 1078-1439; 1873-2496
• DOI: 10.1016/j.urolonc.2008.03.019

Abstract 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 (≤pT2N0) had an abnormal CA-125, and only 1 patient (1/75 = 1.3%) with ≤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.,