Plasma cell-free DNA in ovarian cancer: An independent prognostic biomarker Article

Kamat, AA, Baldwin, M, Urbauer, D et al. (2010). Plasma cell-free DNA in ovarian cancer: An independent prognostic biomarker . 116(8), 1918-1925. 10.1002/cncr.24997

cited authors

  • Kamat, AA; Baldwin, M; Urbauer, D; Dang, D; Han, LY; Godwin, A; Karlan, BY; Simpson, JL; Gershenson, DM; Coleman, RL; Bischoff, FZ; Sood, AK

fiu authors


  • BACKGROUND: Cell-free DNA reflects both normal and tumor-derived DNA released into the circulation through cellular necrosis and apoptosis. The authors sought to determine the role of preoperative total plasma cell-free DNA levels in predicting clinical outcome in patients with ovarian cancer. METHODS: After institutional review board consent, DNA was extracted from plasma of 164 women with invasive epithelial ovarian carcinoma (EOC), 49 with benign ovarian neoplasms, and 75 age-matched controls. The samples were randomly divided into training (n = 144) and validation (n = 144) sets. Quantification of cell-free DNA was performed using real-time polymerase chain reaction for β-globin, and the number of genome equivalents (GE) per milliliter of plasma was determined. Cell-free DNA was correlated with clinicopathologic parameters. RESULTS: The training and validation sets were similar in terms of demographic features. In the training set, EOC patients had a median preoperative cell-free DNA level of 10,113 GE/mL, compared with patients with benign ovarian neoplasms (median, 2365 GE/mL; P < .0001) and controls (median, 1912 GE/mL, P < .0001). Cell-free DNA >22,000 GE/mL was significantly associated with decreased patient survival (P < .001). After adjusting for other clinical variables, preoperative cell-free DNA >22,000 GE/mL was an independent predictor (P = .02) for disease-specific survival. Analysis of the validation set confirmed significantly higher cell-free DNA levels in EOC (median, 13,672 GE/mL) and that cell-free DNA >22,000 GE/mL was associated with a 2.83-fold increased risk of death from disease (P < .001). CONCLUSIONS: Preoperative plasma total cell-free DNA levels are significantly elevated in patients with EOC. Elevated plasma cell-free DNA is an independent predictor for death from disease in ovarian cancer. © 2010 American Cancer Society.

publication date

  • April 15, 2010

Digital Object Identifier (DOI)

start page

  • 1918

end page

  • 1925


  • 116


  • 8