Abstract

CA125 levels in peritoneal lavage fluid (PLF) has been evaluated as a tumor marker in EOC. PLF samples were obtained by performing peritoneal lavage with 1L 0.9% saline, usually via temporary percutaneous cannulae. The study group comprised 87 EOC and 40 control patients; in controls, peritoneal lavage was performed at laparoscopy. Repeated access was associated with significant problems which curtails the potential of IP monitoring. Overall 25% of peritoneal lavage attempts were unsuccessful. A normal upper limit of 60 U ml⁻¹ was established for PLF CA125. In patients with postoperative disease, pre-treatment PLF and serum CA125 (using a cut-off point of 30 U ml⁻¹) levels were elevated in 66 and 87% of cases, respectively. PLF CA125 had a stronger association with the presence of ascites than with the amount of residual disease. PLF CA125 levels correlated with observed response in 71% of 51 patients with evaluable response, which was not significantly less than the 83% observed for serum CA125. Serial measurement demonstrated that rising PLF CA125 levels can predict relapse but that serum CA125 was at least as good in this respect. PLF CA125 is not a more sensitive tumor marker than its serum counterpart and will contribute little to the management of EOC.