Role of preoperative CA-125 levels in predicting the DFS and OS in epithelial ovarian cancer

Shashidhar V. Karpurmathrmath, Velukuru Sai Vivek, Manjunath I. Nandennavar, Veerandra Angadi, Annalakshmi Sekar


Background: Ovarian cancer has the highest mortality rate among all the other gynaecologic malignancies. Stage I cancer treated with surgery and adjuvant chemotherapy report a 5-year overall survival of 95% while this value significantly drops to 25% in stage IIIC and IV patients. Unfortunately, effective screening methods to detect the early cancer are yet to be identified.

Methods: All the patients diagnosed to have epithelial ovarian carcinoma from January 2012 to December 2014 at our center with pre-treatment CA-125 levels were included in this retrospective study. Disease free survival and overall survival were tabulated either by telephonic conversation or on a regular follow up visit to the hospital.

Results: Among the 69 patients enrolled 38% of the patients were in the age group of 50-60 years. 58% of patients had stage 3 disease up front. mean CA-125 levels were lowest in patients with stage I disease and the highest in stage IV disease with a statistically significant rise in CA-125 levels with the stage of disease. Only 52% of the patients completed the treatment as per protocol. There was a significant negative co relation between the CA-125 levels and survival rates in both the sub groups of patients who received complete and incomplete treatment respectively.

Conclusions: In the present study we would like to conclude that pre-operative CA-125, which has already been included in the screening algorithms like ROCA, has a greater potential to become a prognostic marker. Present study is limited by the small number of patient’s and thus larger multi centric studies with better randomization could establish the role of CA-125 as a prognostication marker.


CA 125, CA ovary, Survival rates

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