Abstract
Background
Women with response to primary treatment for advanced ovarian cancer are said to have progression if CA125 increases more than double the upper normal limit (70 IU/L) on follow-up. It was, however, noted that large section of women with CA125 > 35 IU/L had disease on imaging.
Objective
To compare values of CA125 rise at which radiological recurrence can be detected.
Methods
This is a retrospective observational study where women with advanced epithelial ovarian cancer who underwent interval debulking surgery and completed treatment at Tata Medical Center, Kolkata, India, from 2012 to 2016, and were followed up with Ca125. If CA125 doubled or exceeded 35 IU/L or increased to ≥ 70 IU/L, women were subjected to imaging.
Results
Among 142 women who underwent treatment, 64 women with response to primary treatment had recurrence. Recurrence was noted in two (3%) patients with doubling of Ca125 but ≤ 35 IU/, 18 (24%) patients with CA125 > 35 IU/L and 41 (64%) patients when CA125 was ≥ 70 IU/L. Three patients (5%) with normal CA125 had recurrence. Among the recurrence group, 45 women had R0 during surgery of which 27 (60%) had CA125 ≥ 70 IU/L and 14 (31%) had CA125 > 35 IU/L during recurrence. Sensitivity and specificity of value > 35 IU/L were 30.51% and 33.33%, respectively, with accuracy of 32.03%, while sensitivity and specificity at > 70 IU/L were 69.49% and 66.67%, respectively, with accuracy of 67.97%.
Conclusion
CA125 value of ≥ 70 IU/L is a better predictor of recurrence; however, imaging done when value rises > 35 IU/L would be able to detect significant recurrences early thus allowing early treatment.
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Acknowledgements
I would like to thank the department of Medical Oncology of Tata Medical Center, Kolkata, for providing us with the patient data and encouraging us to conduct the study.
Funding
This study was not funded by any organization.
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Dr. Pesona Grace Lucksom helped in designing the work and wrote the paper. Dr. Pesona Grace Lucksom, Dr. Sonia Mathai and Dr. Anik Ghosh helped in collection and interpretation of the data. Dr. Jaydip Bhaumik helped in drafting the work or revising it critically for important intellectual content. All the authors have approval of the version submitted for publication. All authors have agreed to be accountable for all aspects of the work.
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There is no conflict of interest among the authors.
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The study has been approved by the institutional ethics committee (Tata Medical Center) for publication.
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IRB waiver No: EC/WV/TMC/010/19.
Informed Consent
This was a retrospective cohort study and hence did not require consent.
Research Involving Human Participants and/or Animals
This is an observational study and did not involve any interventional research involving Human participants and/or Animals.
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Dr. Pesona Grace Lucksom is a MBBS, MS (OBG), Fellowship in Gynaecology Oncology, Associate Professor OBG at Sikkim Manipal Institute of Medical Sciences, 5th Mile Tadong, East Sikkim, 737102, India. Dr. Pesona G Lucksom is at Tata Medical Center, Kolkata, India. Dr. Sonia Mathai is a MBBS, MS (OBG), Fellowship in Gynaecology Oncology, Project Consultant (SyMeC) at Tata Medical Center, 14 MAR New Town, Rajarhat, Kolkata, 700156, India. Dr. Jaydip Bhaumik is a MBBS, MD, MPH, Senior Consultant and Head of Department, Gynaecology Oncology at Tata Medical Center, 14 MAR New Town, Rajarhat, Kolkata, 700156, India. Dr. Anik Ghosh is a MBBS, MS, Fellowship in Gynaecology Oncology, Junior Consultant (Gynaecology Oncology) at Tata Medical Center, 14 MAR New Town, Rajarhat, Kolkata, 700156, India.
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Lucksom, P.G., Mathai, S., Bhaumik, J. et al. Evaluation of CA-125 as an Indicator of Imaging During Follow-up of Carcinoma Ovary: Original Research. J Obstet Gynecol India 70, 289–294 (2020). https://doi.org/10.1007/s13224-020-01321-9
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DOI: https://doi.org/10.1007/s13224-020-01321-9