Serum CA 125, carcinoembryonic antigen, and CA 19-9 as tumor markers in borderline ovarian tumors

Objectives. The goals of this study were to analyze preoperative serum leve ls of CA 125, carcinoembryonic antigen (CEA), and CA 19-9 in patients with borderline ovarian tumors and to investigate if routine assessment of these markers in follow-up may lead to earlier detection of recurrence. Methods. For patient identification a database was used, in which data from all patients treated for gynecologic malignancies in the Department of Gyn ecologic Oncology, University Hospital Groningen, The Netherlands, are comp iled. Between 1982 and 1997, 44 patients with borderline ovarian tumors wer e identified. Clinical data and serum CA-125 and CEA levels were retrieved from the database. CA 19-9 levels were determined in retrospect in availabl e stored preoperative (24 patients) and follow-up (43 patients) serum sampl es. Results. Preoperative CA 125 levels were elevated in 8 of 33 (24%), CEA lev els in 3 of 32 (9%), and CA 19-9 levels in 11 of 24 (46%) cases. In patient s with mucinous tumors preoperative CA 19-9 was more frequently elevated (8 /14, 57%) than CA 125 (3/20, 15%) (P = 0.02) or CEA (2/18, 11%) (P = 0.02). Complete follow-up serum CA 125, CEA, and CA 19-9 levels were available fo r 43 of 44 patients. Median follow-up was 84 months (range, 22-204). During follow-up two patients (5%) had recurrent disease. In one patient CA 125 b ecame elevated at the time of recurrence; in the other patient (in retrospe ct) the CA 19-9 level did not return to normal after surgery, but kept risi ng, preceding clinical symptoms of recurrence for 13 months. Conclusions. If one chooses to use serum markers in follow-up of mucinous b orderline ovarian tumors CA 19-9 should be included. Measurement of serum t umor markers in the follow-up of patients with borderline ovarian tumors ma y lead to earlier detection of recurrence in only a very small proportion o f patients, while the clinical value of earlier detection of recurrence rem ains to be established. (C) 2000 Academic Press.