Publication:

Role of preoperative CA-125 levels in predicting the DFS and OS in epithelial ovarian cancer

Background Ovarian cancer has the highest mortality rate among all the other gynaecologic malignancies. Stage I cancer treated with surgery and adjuvant chemotherapy report a 5-year overall survival of 95% while this value significantly drops to 25% in stage IIIC and IV patients. Unfortunately, effective screening methods to detect the early cancer are yet to be identified.

Methods All the patients diagnosed to have epithelial ovarian carcinoma from January 2012 to December 2014 at our center with pre-treatment CA-125 levels were included in this retrospective study. Disease free survival and overall survival were tabulated either by telephonic conversation or on a regular follow up visit to the hospital.

Results Among the 69 patients enrolled 38% of the patients were in the age group of 50-60 years. 58% of patients had stage 3 disease up front. mean CA-125 levels were lowest in patients with stage I disease and the highest in stage IV disease with a statistically significant rise in CA-125 levels with the stage of disease. Only 52% of the patients completed the treatment as per protocol. There was a significant negative co relation between the CA-125 levels and survival rates in both the sub groups of patients who received complete and incomplete treatment respectively.

Conclusions In the present study we would like to conclude that pre-operative CA-125, which has already been included in the screening algorithms like ROCA, has a greater potential to become a prognostic marker. Present study is limited by the small number of patient’s and thus larger multi centric studies with better randomization could establish the role of CA-125 as a prognostication marker.