A predictive and prognostic model for surgical outcome and prognosis in ovarian cancer computed by clinico-pathological and serological parameters (CA125, HE4, mesothelin)

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

Abstract

Numerous prognostic models have been proposed for ovarian cancer, extending from single serological factors to complex gene-expression signatures. Nonetheless, these models have not been routinely translated into clinical practice. We constructed a robust and readily calculable model for predicting surgical outcome and prognosis of ovarian cancer patients by exploiting commonly available clinico-pathological factors and three selected serum parameters. Serum CA125, human epididymis protein 4 (HE4) and mesothelin (MSL) were quantified by Lumipulse® G chemiluminescent enzyme immunoassay (Fujirebio) in a total of 342 serum samples from 190 ovarian cancer patients, including 152 paired pre- and post-operative samples. Detection of pre-operative HE4 and CA125 was the optimal marker combination for blood-based prediction of surgical outcome (AUC=0.86). We constructed a prognostic model, computed by serum levels of pre-operative CA125, post-operative HE4, post-operative MSL and surgical outcome. Prognostic performance of our model was superior to any of these parameters alone and was independent from BRCA1/2 mutational status. We subsequently transformed our model into a prognostic risk index, stratifying patients as "lower risk"or "higher risk". In "higher risk"patients, relapse or death was predicted with an AUC of 0.89 and they had a significantly shorter progression free survival (HR: 9.74; 95% CI: 5.95-15.93; p<0.0001) and overall survival (HR: 5.62; 95% CI: 3.16-9.99; p<0.0001) compared to "lower risk"patients. We present a robust predictive/prognostic model for ovarian cancer, which could readily be implemented into routine diagnostics in order to identify ovarian cancer patients at high risk of recurrence.

Details

Original languageEnglish
JournalClinical chemistry and laboratory medicine
Publication statusPublished - 2023
Peer-reviewedYes

External IDs

PubMed 37816681
Mendeley 852aedfc-4a03-3863-8f2d-b037ac08a765

Keywords

Sustainable Development Goals

Keywords

  • CA125, HE4, mesothelin, ovarian cancer, prognostic model