What is the role of serum CA 125 testing in determining prognosis of ovarian carcinoma?

Updated: Jan 10, 2020
  • Author: Gentry George T King, MD; Chief Editor: Eric B Staros, MD  more...
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Answer

Answer

Increased levels of CA 125 have been shown to be independent prognostic factors for survival in ovarian carcinoma. One study showed that patients with a preoperative CA 125 level above 65 kU/L had a statistically significant lower 5-year survival likelihood, conferring a 6.37-fold risk of death compared with levels lower than 65 kU/L. [14]

Similarly, a study by Nasioudis et al found that in patients with stage-1 ovarian sex cord-stromal tumors, those with an elevated serum CA 125 level prior to cancer surgery had a worse 5-year overall survival rate (86.8%) than did patients in whom serum CA 125 was not elevated (94.8%). Worse survival in association with elevated CA 125 was further supported after the investigators controlled for patient age, comorbidities, tumor histology, tumor size, and the performance of lymphadenectomy. [15]

In addition to the absolute level, the half-life of CA 125 is also a prognosticator for survival, with one study showing a half-life of less than 20 days correlating with improved survival. The same study also showed that the postoperative nadir of CA 125 was also a powerful predictor of survival. [14]


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