Connect
MJA
MJA

Beyond evidence: reappraising use of CA-125  as post-therapy surveillance for ovarian cancer

Paul Harnett, Ian H Kerridge, Christopher F C Jordens, Kim Hobbs, Catherine Mason and Bronwen M Morrell
Med J Aust 2012; 196 (7): . || doi: 10.5694/mja11.10889
Published online: 16 April 2012

Reconsidering the place of disease monitoring after treatment

Women who have completed primary chemotherapy for ovarian cancer commonly have serial assessment of the serum tumour marker cancer antigen 125 (CA-125).1 This practice has been based on the proven utility of CA-125 in diagnostic algorithms and as a marker of response to therapy. Serial CA-125 assessment is also used because there is evidence that in women who have completed treatment for ovarian cancer, the serum CA-125 rises 2–6 months before symptoms or signs of relapse develop. The assumption underlying this and other similar studies is that serial monitoring of CA-125 would enable early diagnosis and treatment of relapse. This would thus lead to delay or reduction of cancer-related symptoms, psychological reassurance and, in theory, improved survival.1


  • 1 Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW.
  • 2 Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, NSW.
  • 3 Sydney West Cancer Network, Sydney, NSW.


Correspondence: bronwenmorrell@gmail.com

Competing interests:

No relevant disclosures.

  • 1. Hennessy BT, Coleman RL, Markman M. Ovarian cancer. Lancet 2009; 374: 1371-1382.
  • 2. Rettenmaier NB, Rettenmaier CR, Wojciechowski T, et al. The utility and cost of routine follow-up procedures in the surveillance of ovarian and primary peritoneal carcinoma: a 16-year institutional review. Brit J Cancer 2010; 103: 1657-1662.
  • 3. Rustin GJ, Timmers P, Nelstrop A, et al. Comparison of CA-125 and standard definitions of progression of ovarian cancer in the intergroup trial of cisplatin and paclitaxel versus cisplatin and cyclophosphamide. J Clin Oncol 2006; 24: 45-51.
  • 4. Rustin GJ, van der Burg ME, Griffin CL, et al; MRC OV05; EORTC 55955 investigators. Early versus delayed treatment of relapsed ovarian cancer (MRC OV05/EORTC 55955): a randomised trial. Lancet 2010; 376: 1155-1163.
  • 5. Schwartz PE. Fifth Alon Dembo memorial workshop: case 3. Int J Gynecol Cancer 2010; 20 (11 Suppl 2): S24-S26.
  • 6. Smith TJ. Evidence-based follow-up of lung cancer patients. Semin Oncol 2003; 30: 361-368.
  • 7. Sheppard C. Breast cancer follow-up: literature review and discussion. Eur J Oncol Nurs 2007; 11: 340-347.
  • 8. Harris L, Fritsche H, Mennel R, et al. American Society of Clinical Oncology 2007 update of recommendations for the use of tumor markers in breast cancer. J Clin Oncol 2007; 25: 5287-5312.
  • 9. Calhoun EA, Fishman DA, Lurain JR, et al. A comparison of ovarian cancer treatments: analysis of utility assessments of ovarian cancer patients, at-risk population, general population, and physicians. Gynecol Oncol 2004; 93: 164-169.
  • 10. Australian Cancer Network and National Breast Cancer Centre. Clinical practice guidelines for the management of women with epithelial ovarian cancer. Sydney: National Breast and Ovarian Cancer Centre, 2004. http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/cp98.pdf (accessed Mar 2012).

Author

remove_circle_outline Delete Author
add_circle_outline Add Author

Comment
Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.