Preoperative CA-125 level as a predictor of non optimal cytoreduction of advanced epithelial ovarian cancer

BACKGROUND: Suboptimal cytoreduction of advanced ovarian cancer is related to initial tumor bulk which correlates with CA125 level. METHODS: Retrospective record study of 40 patients with stage III ovarian cancer. The ability of a CA125 threshold level of 500 U/mL to predict suboptimal cytoreduction was determined. RESULTS: Twenty-four (60%) of the patients were optimally cytoreduced. At the CA125 cut off level of 500 U/mL the sensitivity for predicting suboptimal debulking was 62% and specificity was 83%. Above a CA 125 level of 1500 U/mL none of the patients were optimally cytoreduced. CONCLUSIONS: More data are needed to determine the CA125 cut off level at which the standard approach of initial laparotomy and cytoreduction may be modified.