Is preoperative CA-125 level a predictor of cytoreduction in carcinoma ovary?
Journal Title: Indian Journal of Obstetrics and Gynecology Research - Year 2018, Vol 5, Issue 4
Abstract
Optimal cytoreduction of advanced EOC has profound impact on the survival and prognosis of patients3 Suboptimal cytoreduction of advanced ovarian cancer is related to initial tumor bulk which indirectly correlates with serum CA125 levels Can assessment of level of CA 125 in preopererative period predict optimal cytoreduction is the aim of the study The mean age of the 70 patients in this study was 499 years SD 1175 Range 2169 years Fourty four 63 had stage IIIV disease Sixty five 93 patients had papillary serous ovarian cancer The serum CA125 levels ranged from 6 5300 Uml with median preoperative serum CA125 level for all the patients being 259 Uml IQR 68298Uml The level was elevated 35 Uml in 49 of patients with stage compared with 93 of patients with stage or V disease Optimal tumor cytoreduction was obtained in 6170 cases 87 of total patients and in 3544 80 of patients with stage IIIV disease Diaphragmatic stripping appendecetomy rectosigmoid resection and anastomosis pelvic peritonectomy peritoneal stripping debulking of peritoneal disease hemicolectomy ileo colic anastomosis and partial nephrectomy Most of our patients were in intermediate surgical complexity category with a score between 47 In 9 patients all belonging to advanced stage suboptimal cytoreduction was done due to multiple comorbidities multiple mesenteric lymphnode involvement multiple small bowel and liver parenchymal deposits and patient not willing for colostomy An ROC curve analysis showed threshold value of CA125 of 411Uml With a cutoff of 411Uml 97 of total patients with CA125 levels lower than 411Uml were able to undergo optimal cytoreduction Also in 76 of patients with CA125 level more than 411Uml optimal cytoreduction could be achieved When only advanced stages stage IIIIV were considered with a cutoff of 411Uml 88 of patients with CA125 levels lower than 411Uml were able to undergo optimal cytoreduction Also in 73 of patients with CA125 level more than 411Uml optimal cytoreduction could be achieved With a preoperative cutoff value of CA125 more than 411Uml the sensitivity that is probability to predict suboptimal cytoreduction was 65 and specificity that is probability to predict optimal cytoreduction was only 67 Which showed poor predictability for resectability which was in concordance with other studies Though it is difficult to draw definite conclusKeywords Carcinoma ovary CA125 Cytoreduction Surgical complexicity score
Authors and Affiliations
Sumangala G, Premalatha T S, Geeta Acharya, Kiran Kulkarni, Vishakha Bidkar
Keywords
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- EP ID EP475997
- DOI 10.18231/2394-2754.2018.0116
- Views 67
- Downloads 0
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