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CA-125 Predicts Surgery Needs in Ovarian Cancer

This study reviewed 277 patients with advanced ovarian, tubal or peritoneal carcinoma who underwent primary cytoreductive surgery between 2001-2005. The study found that while preoperative CA-125 levels alone did not predict cytoreductive outcome, patients with CA-125 levels over 500 U/mL required extensive upper abdominal surgery 50% of the time to achieve a residual tumor size of 1 cm or less, compared to 27% of patients with CA-125 under 500 U/mL. The results suggest that high preoperative CA-125 levels may be useful in surgical planning by indicating when more extensive abdominal procedures will likely be needed.

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Praveen Ravishankaran
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8 views1 page

CA-125 Predicts Surgery Needs in Ovarian Cancer

This study reviewed 277 patients with advanced ovarian, tubal or peritoneal carcinoma who underwent primary cytoreductive surgery between 2001-2005. The study found that while preoperative CA-125 levels alone did not predict cytoreductive outcome, patients with CA-125 levels over 500 U/mL required extensive upper abdominal surgery 50% of the time to achieve a residual tumor size of 1 cm or less, compared to 27% of patients with CA-125 under 500 U/mL. The results suggest that high preoperative CA-125 levels may be useful in surgical planning by indicating when more extensive abdominal procedures will likely be needed.

Uploaded by

Praveen Ravishankaran
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd

bstract

OBJECTIVE:
We previously reported that preoperative CA-125 may predict primary cytoreductive outcome in
patients with stage III ovarian carcinoma (OC). The objective of this study was to perform a
contemporary analysis of the ability of CA-125 to predict cytoreductive outcome in advanced OC
since our programmatic change in surgical approach that currently incorporates the utilization of
extensive upper abdominal procedures, as needed, to achieve maximal cytoreduction.
METHODS:
We reviewed the records of all patients with advanced ovarian, tubal or peritoneal carcinoma who
underwent primary cytoreduction at our institution between 1/01 and 4/05.
RESULTS:
The study cohort included 277 patients. Primary disease sites were: ovary, 232 (84%); tubal, 9
(3%); and peritoneum, 36 (13%). Stages were: IIIA, 6 (2%); IIIB, 12 (4%); IIIC, 215 (78%); and IV,
44 (16%). Tumor grades were: grade 1, 6 (2%); grade 2, 30 (11%); grade 3, 233 (84%), and
undifferentiated, 8 (3%). Cytoreductive outcomes were: no gross residual disease (RD), 68
(25%); <or=1 cm RD, 153 (55%); and >cm RD, 56 (20%). There was no threshold CA-125 level
that accurately predicted cytoreductive outcome. However, with CA-125 values >500 U/mL, 50%
(57/113) of patients required extensive upper abdominal surgery to achieve RD <or=1 cm,
compared to 27% (25/93) for those with CA-125 <500 U/mL (P=0.001).
CONCLUSION:
Following our change in surgical paradigm that the incorporated extensive upper abdominal
procedures to attain optimal debulking, preoperative CA-125 did not predict the primary
cytoreductive outcome of patients with advanced ovarian, tubal, or peritoneal carcinoma.
However, with a preoperative CA-125 >500 U/mL, extensive upper abdominal procedures were
necessary in 50% of cases to achieve residual disease <or=1 cm. These data may be useful as
part of preoperative surgical counseling and planning.

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