The serial levels of the serum tumor marker CA125 were compared with the results of concurrent abdominopelvic CT scans throughout the clinical course of 65 patients undergoing treatment for advanced epithelial ovarian carcinoma at this institution. Twenty-three of these patients subsequently underwent a second laparotomy following chemotherapy, and the pathological findings were correlated with the preoperative results of both the serum CA125 levels and CT scan appearances in order to establish the relative accuracies of the two tests in the diagnosis of residual disease. Initially, all patients had an elevated CA125 level (< 400 units ml-1) which fell to normal following treatment in all cases. Seventy-five percent of patients showed continuing evidence of disease on CT grounds when both clinical examination and serum CA125 levels had normalized during or following treatment. Patients whose maximum response was PR on CT criteria relapsed faster than those achieving CR, showing CT to be a useful indicator of residual disease when the CA125 level has normalized after chemotherapy. Comparing the CT results and CA125 levels after second-look surgery in 23 patients showed CT to have a sensitivity of 85% and specificity of 42%; CA125 had a sensitivity of 50% with a specificity of 100%. Using this data, a protocol for monitoring patients undergoing treatment and follow-up for ovarian carcinoma is suggested.
- CT scanning
- serum CA125.
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