ESGO statement on the role of CA-125 measurement in follow-up of epithelial ovarian cancer.

T he recent publication of the OV05/EORTC 55955 study on the use of Cancer Antigen 125 (CA-125) in the followup of patients with ovarian cancer after primary treatment has challenged the assumed advantage of early detection of recurrent disease on the basis of a CA-125 rise. This study suggests that despite earlier initiation of second-line treatment, there is no survival benefit. Publication and subsequent review of these European data gave rise to a generalized conclusion that CA-125 monitoring should be abandoned routinely for disease monitoring after treatment. In an accompanying paper in this issue, a European Society of Gynaecological Oncology (ESGO) consensus group has reviewed current data on the use of CA-125 in the follow-up of patients with ovarian cancer. As the conclusions of the OV05/EORTC 55955 study are only applicable for a particular group of patients with ovarian cancer, there is a danger that the conclusion that CA-125 follow-up does more harm than good is also extended to patients that would or could possibly benefit from CA-125 follow-up. The ESGO therefore advises that the use of CA-125 should not be universally abandoned in the routine follow-up of all patients with ovarian cancer. We recommend to consider CA-125 follow-up in the following cases: Patients after complete response on primary treatment for epithelial ovarian cancer who: & have been or are being treated as part of a clinical trial; & are considered for (future) studies on second-line treatment; & will not have routine (3 monthly) follow-up including regular imaging; and & are eligible for secondary surgery at recurrence.