CA-125 levels after surgical exploration and radioactive chromic phosphate in ovarian cancer patients.
Trends in CA-125 levels after completion of therapy in ovarian cancer patients who received intraperitoneal radioactive chromic phosphate therapy (32P) after primary surgical resection or second-look surgery were evaluated. Ninety patients who underwent surgical exploration and 32P were reviewed. Twenty-nine patients were excluded due to insufficient number of CA-125 levels or recurrence within 12 months, with 61 patients with serial CA-125 levels and no evidence of disease for 12 months available for analysis. 32P followed initial resection in 24 patients (16 Stage I, 3 Stage II, 5 Stage III). 32P followed chemotherapy and second-look procedures in 37 patients (4 Stage I, 3 Stage II, 27 Stage III, 3 Stage IV). Elevated CA-125 levels were present in 25 (41%) patients within 12 months of 32P (46% after primary exploration, 38% after second-look). The degree of CA-125 elevation (U/ml) was 30-100 (23%), 100-200 (11%), and >200 (7%). Of the 25 patients with an elevated CA-125, the elevation persisted more than 4 months in 11 (44%). All but two patients had normal CA-125 levels by 12 months. An abnormal elevation in CA-125 was seen in 33% of patients 4 months after receiving 32P and abdominal surgery, with values ranging as high as 500 U/ml. Although elevations in CA-125 are reported following surgery alone, the duration of elevation appears to be longer with 32P. Therefore, persistent elevations of CA-125 following 32P between 4 and 12 months should be judged with caution as they may not reflect recurrent disease.
Department of Obstetrics and Gynecology, University of Louisville School of Medicine, Kentucky 40292, USA.
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Makhija
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Spanos
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Doering
D018394:CA-125 Antigen / Q000378:metabolism*; D017608:Chromium Compounds / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007274:Injections, Intraperitoneal; D010051:Ovarian Neoplasms / Q000378:metabolism / Q000532:radiotherapy* / Q000601:surgery*; D010710:Phosphates / Q000627:therapeutic use*; D010761:Phosphorus Radioisotopes / Q000627:therapeutic use*; D011184:Postoperative Period; D012086:Reoperation; D012189:Retrospective Studies
D018394:CA-125 Antigen; D017608:Chromium Compounds; D010710:Phosphates; D010761:Phosphorus Radioisotopes; C509369:chromic phosphate