Prediction value of serum Ca 125 level in benefit secondary cytoreduction in advanced ovarian cancer patients

The aim of the study was to estimate whether during the first line chemotherapy Ca 125 serum level could indicate the most appropriate moment for successful secondary cytoreduction in epithelial ovarian cancer patients.
We analyzed the value of the serum Ca 125 concentration in 42 patients with FIGO stage III and IV epithelial ovarian cancer qualified for the second cytoreductive surgery on the basis of the clinical and ultrasound examination, independently of the chemotherapy course. Serum Ca 125 concentration was determined at the start of each course of paclitaxel/platinum by a commercial enzyme immunoassay. The predicting optimal cytoreduction of Ca 125 level and most clinically useful Ca 125 cutoff value were determined using the statistical Whitney-Mann test and receiver operating characteristic curve.
Optimal second cytoreduction was performed in 29 patients (69%) using the diameter of the largest residual tumor mass of less than 1 cm. Mean serum Ca 125 concentrations in this group reached values of 101.88 U/ml. In 13 women (31%) not optimally debulking, Ca 125 level reached the mean value of 542.41 U/ml. The most suitable Ca 125 cutoff value was 81.28 U/ml. The positive predictive value reached 88% and the negative predictive value reached 64%.
Our results showed that serum
Ca 125 level of 100 U/ml or less can indicate the most appropriate moment for interval debulking surgery independent of the number of the chemotherapy courses applied before.