Blogger's Note: past studies also confirm the connection between doubling of CA125/nadir, focus on remote care/followup
Journal of Ovarian Research | Abstract | The value of serum CA125 for the development of virtual follow-up strategies for patients with epithelial ovarian cancer: A retrospective study
Research
"Current NCCN guidelines for the follow up of patients with EOC are widely accepted but only limited evidence is available to support current clinical practice [3]. There are no clinical trials available to determine optimal follow up intervals, sequence or duration of follow up."
The value of serum CA125 for the development of virtual follow-up strategies for patients with epithelial ovarian cancer: A retrospective study
Published: 22 March 2012
Abstract (provisional)
Background
Serum CA125 is routinely used in the follow up of ovarian cancer. The objective of
the present study was to evaluate the usefulness of CA125 in the detection of ovarian
cancer recurrence.
Methods
This retrospective case study was carried out at a tertiary gynaecological cancer
centre in Australia. Patients with all cell types of epithelial ovarian cancer (EOC)
treated between 2003 and 2010 were considered eligible. We excluded patients whose
aim of treatment was palliative, had no follow-up, had no pre-operative CA125 reading
or had pre-operative CA125 levels < 35 U/mL. After primary treatment, patients were
followed up as per guidelines suggested by National Comprehensive Cancer Network (NCCN).
We recorded if symptoms, findings from physical examination, imaging or serum CA125
levels led to the diagnosis of recurrence. An increase in CA125 levels to twice the
postoperative nadir was considered as "doubling" at any time during follow up.
Results
Analysis is based on 56 patients who completed primary treatment and who presented
for a total of 274 follow-up episodes. Of those, 29 patients (52%) developed a recurrence
within the follow up period. Recurrence was diagnosed by CA125 alone in 14 of 29 patients
(48%). CA125 was not elevated in 7 patients (24%) who recurred. Doubling of CA125
from nadir was observed in 27/29 patients. Of those 27 patients the doubling from
nadir occurred within the normal range of 35 U/ml in 3 cases and outside the normal
range in 24 cases. Multivariate analysis suggests that doubling of serum CA125 (OR
5.10, p 0.036) and nadir CA125 >10 U/ml (OR 2.86, p 0.01) remained the only independent
factors to predict ovarian cancer recurrence.
Conclusions
The present paper proposes the validation of a novel CA125 algorithm aiming to detect
recurrent EOC. These data may allow us to investigate novel ways of follow up that
do not require a patient's physical attendance at a clinic (virtual follow-up).
