Abstract

The relationship between different CA125 parameters and survival in patients with epithelial ovarian cancer was investigated in a prospective study. This involved 161 patients of whom 64 died and 97 remained alive. The established prognostic factors of stage and residual disease were controlled for and the population characteristics (age, follow-up/survival duration, histologic subtype, grade) were comparable in the ‘dead’ and ‘alive’ groups. For patients with stage I and II disease preoperative serum CA125, pre-chemotherapy serum CA125, plateau serum CA125 and time to reach the plateau level were all higher in the non-survivors when compared with survivors. In contrast, preoperative serum CA125 and pre-chemotherapy serum CA125 were significantly higher in survivors with stage III and IV disease. A possible explanation for these results includes the suggestion that early- and late-stage ovarian cancer may be different ‘diseases’ with different natural histories rather than being a continuum. Alternatively, the tumor-associated antigen CA125 being a membrane glycoprotein may have a beneficial, perhaps immunologic role in advanced disease.