An assessment of the value of serum CA 125 measurements in the management of epithelial ovarian carcinoma.

The records of 223 patients with epithelial ovarian carcinoma treated at Westmead Hospital and King George V Hospital between 1985 and 1991 were studied retrospectively to compare CA 125 levels with the clinical course of their disease. CA 125 parameters and established predictors of disease were compared using a Cox multivariate analysis to determine their relative prognostic value. The CA 125 trend was the most significant variable followed by the FIGO stage. The initial CA 125 level and nadir CA 125 level, although significant when considered alone, were not significant independent variables. The threshold for a raised CA 125 level was also considered and we propose that a lower level of 15 u/ml may be more useful as a cutoff when following patients with a known history of ovarian carcinoma. The rationale for this is that patients in our study with a nadir level in the intermediate range (15-35 u/ml) invariably developed recurrent disease.