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Fifth Alon Dembo Memorial Workshop: Case 3
  1. Peter E. Schwartz, MD
  1. Yale University School of Medicine, New Haven, CT.
  1. Address correspondence and reprint requests to Peter E. Schwartz, MD, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06520. E-mail: peter.schwartz{at}


Background: OVO5/EORTC 55855, a study punitively refuting the value of CA-125 in the follow-up of ovarian cancer patients, has many deficiencies, including a heterogeneous ovarian cancer patient population, no control of initial treatment regimens, and no control of subsequent surgery or chemotherapeutic management for recurrence. Recent studies suggest a role for prompt surgery in selected cases of recurrent ovarian cancer with CA-125 elevations, a role for tamoxifen in managing rising CA-125 levels in patients without evidence of disease and the use of platinum doublets for treating recurrent platinum-sensitive disease, none of which were incorporated into OVo5/EORTC 55955.

Case: A patient with advanced stage ovarian cancer presenting with a CA-125 level of 2000 U/mL, who is initially treated with surgery followed by chemotherapy and has a normal CT scan and normal CA-125 at completion of her initial chemotherapy.

Conclusion: This patient remains at a very high risk for recurrence. I would continue to monitor this patient with serial CA-125 levels to identify recurrent cancer and consider initiating treatment before it is clinically obvious.

  • CA-125 and recurrent disease
  • Ovarian cancer
  • OVO5/EORTC 55955

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