Prognostic significance of preoperative serum CEA in primary mucinous ovarian carcinoma: a retrospective cohort study

Purpose: The purpose of this study was to evaluate the prognostic significance of preoperative serum carcinoembryonic antigen (CEA) in primary mucinous ovarian carcinoma (MOC). Patients and methods: We reviewed 57 patients with primary MOC, in whom preoperative serum CEA had been measured. All patients were treated at Peking Union Medical College Hospital between June 1996 and September 2016. Results: Preoperative serum CEA was elevated (>5.0 ng/mL) in 10 patients (17.5%), with a median serum CEA of 9.6 ng/mL (5.4-111.7 ng/mL). CEA was significantly associated with preoperative serum cancer antigen 125 (P=0.002), surgical debulking status (P=0.015), and tumor stage (P=0.001). Univariate analysis showed that patients with elevated CEA had significantly worse overall survival (OS) than patients with normal CEA (5-year OS: 50.8% vs 91.9%, respectively; P=0.013), but there was no significant difference in progression-free survival between the two groups (P=0.307). Multivariate analysis further demonstrated that advanced stage was an independent prognostic predictor for OS (P=0.002, HR: 15.925, 95% CI: 2.745-92.404). Conclusion: Elevated preoperative serum CEA was strongly correlated with advanced stage in primary MOC, which may indicate a poorer prognosis. Further investigation of the intrinsic relationship between CEA and primary MOC is now required.