Correlations of serum CA125 level and computerized tomography (CT) imagingwith laparotomic findings following intraperitoneal chemotherapy in patients with ovarian cancer

The aim of this study was to evaluate the role of serum CA125 levels and co mputerized tomography (CT) scans in predicting pathologic response of intra peritoneal chemotherapy in patients with ovarian cancer. We prospectively a nalyzed serum CA125 levels and abdominopelvic CT scans obtained after the c ompletion of intraperitoneal chemotherapy in 52 patients with ovarian cance r and compared the results with subsequent laparotomic findings, which serv ed as the gold standard for statistical analysis. Laparatomy revealed eithe r microscopic or macroscopic residual disease in 20 patients. while 32 pati ents were completely tumor-foe. CA125 levels correlated significantly with laparotomic findings (p=0.003, u=1405). Median CA125 values in patients wit h residual tumors and in tumor-free patients following intraperitoneal chem otherapy were 14.6 (1-775) and 7.2 (1-37) U/ml, respectively. Although CT-i maging and CA 125 levels had a high specificity (100% and 96.9%, respective ly), they showed a low sensitivity rate (50% and 40%. respectively). Simila rly, despite high positive predictive values( 100% and 88.9% respectively), the negative predictive values were 76.2% and 72.1%, respectively. Conclusion: Although highly specific, CT scans and CA125 levels do not accu rately indicate the presence of disease. Due to a high false-negative rate, a normal CT scan or a normal CA125 value is not sufficient to replace a la parotomy.