The decline of CA 125 level after surgery reflects the size of residual ovarian cancer.
OBJECTIVE
To determine whether the decline in CA 125 level after surgery can predict the extent of residual disease.


METHODS
In a prospective, nonrandomized clinical trial, 27 women with advanced ovarian cancer (stage III or IV) underwent primary or secondary cytoreductive surgery. CA 125 levels were measured before surgery and 3-14 days postoperatively. The mean postoperative decline was compared by size of residual disease.


RESULTS
In women with all visible cancer resected, the mean (+/- standard error of the mean) decline in CA 125 was 91 +/- 4% (1032 +/- 473 U/mL preoperatively to 90 +/- 31 U/mL postoperatively). With less than 2.0 cm residual, there was an 85 +/- 2% decline in CA 125 after surgery (3061 +/- 835 U/mL preoperatively to 456 +/- 146 U/mL postoperatively). In patients with residual disease larger than 2.0 cm, the levels dropped 36 +/- 10% (2958 +/- 1587 to 1904 +/- 708 U/mL). If CA 125 declined less than 60% from the preoperative level, the sensitivity, specificity, and positive and negative predictive values for residual disease larger than 2.0 cm were all 100%.


CONCLUSIONS
By using the ratio of CA 125 levels before and after cytoreductive surgery, one can predict the likelihood that the patient was left with less than 2.0 cm residual disease.
Brand
E
E
Department of Obstetrics and Gynecology, University of Colorado Health Sciences and Cancer Center, Denver.
Lidor
Y
Y
D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000032:analysis*; D014408:Biomarkers, Tumor / Q000032:analysis; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D012086:Reoperation
D015295:Antigens, Tumor-Associated, Carbohydrate; D014408:Biomarkers, Tumor