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Preoperative CA-125 Levels in 123 Patients With Borderline Ovarian Tumors: A Retrospective Analysis and Review of the Literature
  1. Eva Kolwijck, MD*,
  2. Chris M.G. Thomas, PhD,
  3. Johan Bulten, MD, PhD and
  4. Leon F.A.G. Massuger, MD, PhD*
  1. *Departments of Obstetrics and Gynecology,
  2. Departments of Laboratory of Endocrinology and Reproduction, and
  3. Departments of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
  1. Address correspondence and reprint requests to Eva Kolwijck, MD, Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, the Netherlands. E-mail: E.Kolwijck{at}


We studied preoperative CA-125 levels of 123 patients with borderline ovarian tumors (BOTs) and performed an analysis with data of earlier published studies. CA-125 levels were compared according to histology and stage of disease. Preoperative serum CA-125 levels were significantly higher for patients with advanced stage (median, 181 U/mL; range, 413 U/mL) compared with patients with stage I (median, 28 U/mL; range, 1123 U/mL) BOTs and for patients with serous (median, 59 U/mL; range, 1119 U/mL) compared with patients with mucinous (median, 25 U/mL; range, 371 U/mL) BOTs (both P < 0.001, Mann-Whitney U test). A pooled analysis of 3 studies and the present study showed positive rates of CA-125 (value >35 U/mL) in 171 (53%) of 325 patients with BOTs. Positive rates were more often found in patients with serous (67%) compared with patients with mucinous BOTs (39%) and in patients with advanced stage (83%) compared with patients with stage I BOTs (47%) (both P < 0.001, Pearson χ2 test). This main effect was also found for each individual study of the pooled analysis. From a clinical perspective, we believe, on base of the results of this study and the literature, that preoperative discrimination using CA-125 level is especially difficult between patients with stage I ovarian cancer and the group of patients with serous and/or advanced-stage BOTs.

  • CA-125
  • borderline
  • low malignant potential
  • ovarian cancer
  • stage I

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