CA125 level predicts microscopic residual disease in ovarian cancer
LOS ANGELES –
"Preoperative levels of cancer antigen 125 (CA125) predict surgical and
disease outcomes in women with advanced epithelial ovarian cancer who
are able to undergo optimal debulking surgery, new data show, and may
therefore help guide treatment decisions.
A team led by Dr. Neil S. Horowitz of Brigham and
Women’s Hospital and the Dana Farber Cancer Institute in Boston assessed
levels of the biomarker among nearly 1,000 women who had stage III or
IV disease that was optimally debulked to less than 1 cm of residual
disease and who received adjuvant paclitaxel- and platinum-containing
chemotherapy.
Results
showed that no cutoff value of preoperative CA125 levels clearly
separated women in whom microscopic residual disease was achieved
surgically from women in whom a greater volume of disease remained, he
reported at the annual meeting of the Society of Gynecologic Oncology.
But the probability of achieving microscopic status
decreased with increasing CA125 levels. For example, it fell from 33% in
women with a level of 500 U/mL to 27% in women with a level of 1,000
U/mL.
"Although a strict CA125 value to predict
microscopic residual cannot be made, these data are helpful for
counseling patients regarding surgical results and outcome, and should
influence decisions regarding primary debulking surgery and possibly use
of other ... treatment options like neoadjuvant chemotherapy," Dr.
Horowitz said. "Each surgeon and [his or her] patient have to decide for
themselves what is an acceptable probability of successful surgical
outcome to microscopic residual disease.
