Skip to main content Accessibility help
×
Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-28T03:40:13.013Z Has data issue: false hasContentIssue false

Debate 5A - Should CA-125 Surveillance be Performed after Completion of Primary Treatment for Ovarian Cancer Patients in Remission?

Yes

from Section III - Ovarian Cancer

Published online by Cambridge University Press:  20 July 2023

Dennis S. Chi
Affiliation:
Memorial Sloan-Kettering Cancer Center, New York
Nisha Lakhi
Affiliation:
Richmond University Medical Center, Staten Island
Nicoletta Colombo
Affiliation:
University of Milan-Bicocca
Get access

Summary

Changes in serum CA-125 levels predict response to chemotherapy and survival in women with advanced epithelial ovarian cancer. Although often used to monitor for recurrence, randomized trial data do not suggest that treatment based on a rising CA-125 alone impacts prognosis if secondary cytoreduction is not under consideration. CA-125 surveillance may still provide benefits to patients who are likely to achieve a complete resection at secondary cytoreduction – assuming that early identification of recurrent disease based on a rising CA-125 level leads to a higher chance of complete gross resection. CA-125 surveillance also provides patients with useful information about prognosis and impending recurrence – regardless of whether this information impacts survival directly. As such, the routine use of CA-125 surveillance should be considered as an individualized option for patients based on disease characteristics and personal preferences.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Rodriguez, N, et al. Changes in serum CA-125 can predict optimal cytoreduction to no gross residual disease in patients with advanced stage ovarian cancer treated with neoadjuvant chemotherapy. Gynecol Oncol 2012;125:362366. https://doi.org/10.1016/j.ygyno.2012.02.006Google Scholar
Rustin, GJS, et al. Definitions for response and progression in ovarian cancer clinical trials incorporating Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 and CA-125 agreed by the gynecological cancer intergroup (GCIG). Int J Gynecol Cancer 2011;21:419423. https://doi.org/10.1097/IGC.0b013e3182070f17Google Scholar
Fleming, ND, et al. CA-125 surveillance increases optimal resectability at secondary cytoreductive surgery for recurrent epithelial ovarian cancer. Gynecol Oncol 2011;121:249252. https://doi.org/10.1016/j.ygyno.2011.01.014Google Scholar
Piatek, S, et al. Rising serum CA-125 levels within the normal range is strongly associated recurrence risk and survival of ovarian cancer. J Ovarian Res 2020;13:102. https://doi.org/10.1186/s13048-020-00681-0Google Scholar
Pignata, S, et al. Follow-up with CA-125 after primary therapy of advanced ovarian cancer: in favor of continuing to prescribe CA-125 during follow-up. Ann Oncol Off J Eur Soc Med Oncol 2011;22(Suppl. 8):viii40–viii44. https://doi.org/10.1093/annonc/mdr470Google Scholar
Rustin, GJS, et al. Early versus delayed treatment of relapsed ovarian cancer (MRC OV05/EORTC 55955): a randomised trial., Lancet 2010;376:11551163. https://doi.org/10.1016/S0140-6736(10)61268-8Google Scholar
Coleman, RL, et al. Secondary surgical cytoreduction for recurrent ovarian cancer. N Engl J Med 2019;381:19291939. https://doi.org/10.1056/NEJMoa1902626Google Scholar
Du, Bois A, et al. Randomized phase III study to evaluate the impact of secondary cytoreductive surgery in recurrent ovarian cancer: final analysis of AGO DESKTOP III/ENGOT-ov20. J Clin Oncol 2020;38:6000. https://doi.org/10.1200/JCO.2020.38.15_suppl.6000Google Scholar
Tanner, EJ, et al. Surveillance for the detection of recurrent ovarian cancer: survival impact or lead-time bias? Gynecol Oncol 2010;2010:117. https://doi.org/10.1016/j.ygyno.2010.01.014Google Scholar
Jordens, CFC, et al. Cancergazing? CA-125 and post-treatment surveillance in advanced ovarian cancer. Soc Sci Med 2010;71:15481556. https://doi.org/10.1016/j.socscimed.2010.07.033Google Scholar
Tsai, L-Y, et al. Life experiences and disease trajectories in women coexisting with ovarian cancer. Taiwan J Obstet Gynecol 2020;59:115119. https://doi.org/10.1016/j.tjog.2019.11.032Google Scholar
Jolicoeur, LJA, et al. Women’s decision-making needs related to treatment for recurrent ovarian cancer: a pilot study. Can Oncol Nurs J 2009;19:117121. https://doi.org/10.5737/1181912x193117121Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×