title: Predictive value of serial CA 125 antigen levels in ovarian cancer evaluated by second-look laparotomy.
abstract: Serial serum CA 125 levels were measured before definitive surgery and during chemotherapy for 12 months or more in 64 patients with ovarian cancer. In the 42 patients who had a complete clinical remission and thus were subjected to a second-look laparotomy, an absence of disease was not predicted by patterns of CA 125 levels. Whilst rising or persistently high levels indicated the presence of tumour in 92% of patients, declining levels to negative predicted the absence of tumour in only 50%. Although the majority of these patients showed microscopic foci or a tumour mass less than 1 cm, 3 patients had a larger amount of disease. In the follow-up of 49 patients, the accuracy of prediction of a good outcome was better than that of a poor outcome on the basis of CA 125 patterns, with rates of 92% and 79%, respectively. Our findings indicate that CA 125 lacks sensitivity in detecting small tumour masses (less than 1 cm dia.) but rising or persistently high levels suggest a strong likelihood of a residual tumour to be found at a second-look laparotomy.
mesh_terms: D000951:Antigens, Neoplasm / Q000032:analysis*; D015295:Antigens, Tumor-Associated, Carbohydrate; D003131:Combined Modality Therapy; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D011446:Prospective Studies; D012086:Reoperation; D012698:Serologic Tests
chemical_list: D000951:Antigens, Neoplasm; D015295:Antigens, Tumor-Associated, Carbohydrate