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

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