Abstract
I appreciate the comments by Dr. Menczer concerning our paper “Clinical Implications of a Rising Serum CA-125 within the Normal Range in Patients with Epithelial Ovarian Cancer: A Preliminary Investigation” [ [1] Wilder J.L. Pavlik E. Straughn J.M. et al. Clinical implications of a rising serum CA-125 within the normal range in patients with epithelial ovarian cancer: a preliminary investigation. Gynecol. Oncol. 2003; 89: 233-235 Abstract Full Text Full Text PDF PubMed Scopus (60) Google Scholar ]. This paper presents results from a multi-institutional investigation that identified patients with CA-125-producing epithelial ovarian cancers who experienced progressively rising serum CA-125 levels in the normal range (<35 u/ml) after the completion of therapy. All of these patients were in complete remission, as defined by a normal clinical examination, negative imaging studies, and a normal serum CA-125 before experiencing progressively rising serum antigen levels. Eleven patients were identified with these findings from the three participating institutions from 1990 to 2001. All 11 patients developed documented tumor recurrence 3–17 months (mean 6 months) after this marker pattern was identified. We concluded that ovarian cancer patients with a progressively rising serum CA-125 in the normal range are at very high risk of developing recurrence and should be evaluated immediately to rule out or document recurrent cancer.
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