CA-125 LEVELS AFTER SURGICAL EXPLORATION AND RADIOACTIVE CHROMIC PHOSPHATE IN OVARIAN-CANCER PATIENTS

Trends in CA-125 levels after completion of therapy in ovarian cancer patients who received intraperitoneal radioactive chromic phosphate th erapy (P-32) after primary surgical resection or second-look surgery w ere evaluated. Ninety patients who underwent surgical exploration and P-32 were reviewed. Twenty-nine patients were excluded due to insuffic ient number of CA-125 levels or recurrence within 12 months, with 61 p atients with serial CA-125 levels and no evidence of disease for 12 mo nths available for analysis. P-32 followed initial resection in 24 pat ients (16 Stage I, 3 Stage II, 5 Stage III). P-32 followed chemotherap y and second-look procedures in 37 patients (4 Stage I, 3 Stage II, 27 Stage III, 3 Stage IV). Elevated CA-125 levels were present in 25 (41 %) patients within 12 months of P-32 (46% after primary exploration, 3 8% after second-look). The degree of CA-125 elevation (U/ml) was 30-10 0 (23%), 100-200 (11%), and >200 (7%). Of the 25 patients with an elev ated CA-125, the elevation persisted more than 4 months in 11 (44%). A ll but two patients had normal CA125 levels by 12 months. An abnormal elevation in CA-125 was seen in 33% of patients 4 months after receivi ng P-32 and abdominal surgery, with values ranging as high as 500 U/ml . Although elevations in CA-125 are reported following surgery alone, the duration of elevation appears to be longer with P-32. Therefore, p ersistent elevations of CA-125 following P-32 between 4 and 12 months should be judged with caution as they may not reflect recurrent diseas e. (C) 1996 Academic Press, Inc.