Is postoperative CA125 level in patients with epithelial ovarian cancer reliable to guess the optimality of surgery

INTRODUCTION: Cytoreductive surgery is a pivotal component of primary treatment in patients with ovarian epithelial caner (OEC) and several studies have shown better outcomes of optimal debulking. The aim of this prospective study was to determine if optimum versus suboptimal cytoreductive surgery predicts CA125 levels two weeks after surgery. MATERIAL AND METHODS: Sixty patients with epithelial ovarian cancer scheduled for cytoreductive surgery in Imam Khomeini Hospital, Tehran, Iran were enrolled in this study. Two groups of patients were to undergo optimal or suboptimal cytoreductive surgery. Optimal cytoreduction was defined as the largest volume of residual disease < 1 cm in maximal dimension. CA125 levels were measured in all patients preoperatively and at two, seven and 14 days after surgery. CA125 levels were converted to a log scale. RESULTS: The distribution of staging, grading and types of tumors in each group were statistically equal but insignificant (chi square). The difference in mean of CA125 before and two weeks after surgery was statistically significant (paired t-test; p = 0.0001) but the grade, stage and type of tumors did not have any impact on CA125 regression. However, regression of CA125 two weeks after the operation did not differ statistically between the optimal and suboptimal cytoreduction groups (repeated measure ANOVA). CONCLUSION: Although, postoperative CA125 decreased significantly in two weeks after tumor cytoreduction in patients with epithelial ovarian cancer, its regression did not differ according to optimal or suboptimal groups.