A study to evaluate the utility of presurgical CA125 to predict optimal tumor cytoreduction of epithelial ovarian cancer.
OBJECTIVE
To determine the ability of a preoperative serum CA125 to predict optimal primary tumor cytoreduction in patients with stage III and IV epithelial ovarian cancer (EOC).


METHODS
The records of patients with advanced stage who underwent primary surgery for EOC at Tehran University, Vali-Asr Hospital between 2000 and 2002 were reviewed. Inclusion criteria included FIGO stage III/IV disease, surgery by gynecologic oncology faculty, preoperative CA125, and an operative note clearly defining volume of residual disease. Without optimal cytoreduction was determined using the receiver operator curve (ROC).


RESULTS
One hundred and twenty cases of advanced stage EOC were identified, of which 90 cases of stage III/IV met our inclusion criteria. Serum CA125 < or = 400 was identified with OD > or = 75% of the time. Conversely, optimal cytoreduction was performed in < or = 40% of patients with CA125 > or =4000. The area under the ROC curve for CA125 was 0.680. The optimal cytoreduction rate for those with and without ascites was 38% and 77%, respectively (P<0.001). In a multivariate analysis using CA125, age, and ascites, the area under the curve was 0.696.


CONCLUSIONS
We conclude that CA125 level did not reliably predict optimal cytoreduction in patients with stage III-IV EOC.
Gilani
Mitra Modares
MM
Department of Gynecology Oncology, Vali-Asr Hospital, Tehran University of Medical Sciences, Keshavarz Blvd., Tehran, Iran.
Karimi Zarchi
Mojgan
M
Ghaemmaghami
Fatemeh
F
Behtash
Nadereh
N
Mousavi
Azam Sadat
AS
Ansaripoor
Soheila
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018394:CA-125 Antigen / Q000097:blood*; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery*; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012372:ROC Curve
D018394:CA-125 Antigen