Prolonged Symptom-Free Survival in a Patient with Persistent Primary Peritoneal Carcinoma and a Rising CA-125: A Note of Caution

Abstract

Background. The optimal management of patients with ovarian and primary peritoneal carcinomas who experience an elevation of the serum CA-125 antigen level following the completion of therapy, and who remain without other clinical evidence of recurrent/progressive disease, remains controversial.Case. A patient with primary peritoneal carcinoma cared for in the Gynecologic Cancer Program of the Cleveland Clinic Foundation has experienced prolonged symptom-free survival (>4 years) after a documented tripling of her persistently elevated postchemotherapy serum CA-125 without the reinstitution of cytotoxic therapy.Conclusion. This case emphasizes that caution must be exercised when electing to initiate second-line treatment solely on the basis of an abnormal tumor antigen level.