One-shot platelet-rich plasma (PRP) injection is non-inferior to extracorporeal shockwave therapy in the management of supraspinatus tendinosis.

PURPOSE: Supraspinatus tendinosis (ST) refers to the intratendinous degeneration of the supraspinatus tendon. Platelet-Rich Plasma (PRP) is one of the possible conservative treatments for supraspinatus tendinosis. This prospective observational study aims to evaluate the efficacy and safety of a single ultrasound-guided PRP injection in the treatment of supraspinatus tendinosis and to assess its non-inferiority to the widely used shockwave therapy. METHODS: Seventy-two amateur athletes (35 male, mean age: 43.75 ± 10.82, range 21-58 years old) with ST were finally included in the study. All the patients underwent clinical evaluation at baseline, (T0) and at 1-month (T1), 3-month (T2) and 6-month (T3) follow-up using the following clinical scales: the Visual Analogue Scale for pain (VAS), Constant Score and the Disabilities of the Arm, Shoulder and Hand Score (DASH). A T0 and T3 ultrasound examination was also performed. The findings observed in the recruited patients were compared to the clinical results observed in a retrospective control group made up of 70 patients (32 male, mean age = 41.29 ± 13.85, range 20-65 years old) treated by extracorporeal shockwave therapy (ESWT). RESULTS: VAS, DASH and Constant scores significantly improved from T0 to T1; the improvement in clinical scores was kept until T3. No local nor systemic adverse events were observed. An improvement in the tendon structure was observed on ultrasound examination. PRP showed a non-statistical inferiority, in terms of efficacy and safety, compared to ESWT. CONCLUSION: The PRP one-shot injection is a valid conservative treatment to reduce pain, and improve both quality of life and functional scores in patients with supraspinatus tendinosis. Furthermore, the PRP intratendinous one-shot injection showed a non-inferiority in terms of efficacy at the 6-month follow-up, compared to ESWT.

The effect of combined drug therapy in lateral fragility fractures of the femur: a prospective observational study.

OBJECTIVE: Due to a growing number of lateral fragility fractures, and their high economic and social impact, we evaluated the combined drug therapy effectiveness in lateral fragility femur fractures treated by intramedullary nailing surgery comparing the clinical and radiological results of two groups of patients. PATIENTS AND METHODS: From May 2019 to March 2020, we carried out a prospective observational study comparing the results of patients with femoral lateral fractures treated by the same intramedullary nail (PFNA Synthes®) using Clodronic acid and Vitamin D (study group, 25 patients) compared to patients with the same fractures treated with Vitamin D alone (control group, 25 patients). The evaluations were based on bone biochemical markers (serum calcium level, serum phosphate level, parathyroid hormone, Vitamin D, serum C-terminal telopeptide), Visual Analogic Scale and HHS (Harris Hip Score) score, and femur densitometric views. In order to evaluate the femur neck mineral bone density (BMD), two areas have been identified on the Anterior-Posterior view: the Region of Interest (ROI)1 (under the head screw) and the ROI2 (above the femoral screw). The BMD has been calculated using femur densitometric views at T0 (1st day post-surgery) and at T1 (12 months later). RESULTS: As far as the BMD average of ROI1 is concerned, we found a significant statistical increase at T1 in the study group (0.93±0.07 gr/cm2) vs. control group (0.88±0.08 gr/cm2), p=0.04. Both biochemical and densitometric values were statistically increased in the study group from T0 to T1 (p<0.05), while control group showed an improvement in the biochemical values only. CONCLUSIONS: Thanks to a one year follow-up, we are able to demonstrate that the administration of an adequate drug therapy after surgery can lead to a better control of the bone remodeling and reabsorption process.

A Prospective Observational Clinical and Radiological Study of a Modular Bridging External Fixator for Unstable Distal Radius Fractures.

INTRODUCTION: Distal Radius Fractures (DRFs), with a reported annual incidence of 600,000, are common injuries treated by trauma surgeons. This prospective observational study aims to assess the efficacy of a modular external fixation system in the treatment of unstable distal radius fractures at 12-months follow-up. MATERIALS AND METHODS: Between December 2014 and December 2016, 35 patients (female: 21, male:14; mean age: 62.5), with unstable DRFs, treated with modular external fixation system, were selected for this prospective observational study. All the patients underwent clinical and radiological reviews at follow-up. RESULTS: At 12-month follow-up, a mean DASH score of 15.73 and a mean PRWE score 20.10 were recorded. Mean radial inclination was 19.92°; mean ulnar variance was 1.12 mm and mean palmar inclination was 9.76°. CONCLUSION: Modular external fixator system revealed clinically and radiologically effective in the treatment of unstable and comminuted DRFs. Additional K-wires should be used to complement the fracture fixation, when there is unacceptable fragment reduction only with external fixator.

A Prospective Observational Clinical and Radiological Study of a Modular Bridging External Fixator for Unstable Distal Radius Fractures

@#Introduction: Distal Radius Fractures (DRFs), with a reported annual incidence of 600,000, are common injuries treated by trauma surgeons. This prospective observational study aims to assess the efficacy of a modular external fixation system in the treatment of unstable distal radius fractures at 12-months follow-up. Materials and methods: Between December 2014 and December 2016, 35 patients (female: 21, male:14; mean age: 62.5), with unstable DRFs, treated with modular external fixation system, were selected for this prospective observational study. All the patients underwent clinical and radiological reviews at follow-up. Results: At 12-month follow-up, a mean DASH score of 15.73 and a mean PRWE score 20.10 were recorded. Mean radial inclination was 19.92°; mean ulnar variance was 1.12 mm and mean palmar inclination was 9.76°. Conclusion: Modular external fixator system revealed clinically and radiologically effective in the treatment of unstable and comminuted DRFs. Additional K-wires should be used to complement the fracture fixation, when there is unacceptable fragment reduction only with external fixator.

The Endo-Model(®) rotating hinge for rheumatoid knees : Functional results in primary and revision surgery.

BACKGROUND: Major joints of the lower limbs are commonly affected by rheumatoid arthritis (RA), with consequent pain, loss of function, and progressive disability. Knee replacement represents a useful solution, but a highly constrained implant design is often needed in order to face the severe anatomical deformities and the gross instability that the surgeon may encounter in the rheumatoid knee. OBJECTIVES: The aim of this work was to evaluate the Endo-Model(®) rotating hinge knee prosthesis implanted in patients affected by RA and severely damaged knees. PATIENTS AND METHODS: We retrospectively evaluated a series of 38 patients with RA implanted with the Endo-Model(®) rotating hinge knee prosthesis for primary or revision surgery (mean follow-up 6.1 years; mean age at surgery 71.5 years). At the time of surgery, the mean duration of RA was 13.2 years. Patients were evaluated clinically and radiographically and the Knee Society Score (KSS) was used. RESULTS: Implant survival at most recent follow-up was 91.7 %. Mean final knee flexion was 102.7 °. The mean KSS was 93.5 (excellent) and 67.1 (good) for clinical and functional score, respectively. Mild pain was present in 10 patients. No sign of malalignment or residual instability was found. No evidence of loosening or implant failure was observed in x-rays. CONCLUSION: The Endo-Model(®) rotating hinge knee prosthesis provides excellent pain relief, functional recovery, and intrinsic knee stability both in complex primary and in revision knee arthroplasty in the majority of patients with severely affected rheumatoid knees.

Adversity in childhood and depression: linked through SIRT1.

Experiencing an adverse childhood and parental neglect is a risk factor for depression in the adult population. Patients with a history of traumatic childhood develop a subtype of depression that is characterized by earlier onset, poor treatment response and more severe symptoms. The long-lasting molecular mechanisms that are engaged during early traumatic events and determine the risk for depression are poorly understood. In this study, we altered adult depression-like behavior in mice by applying juvenile isolation stress. We found that this behavioral phenotype was associated with a reduction in the levels of the deacetylase sirtuin1 (SIRT1) in the brain and in peripheral blood mononuclear cells. Notably, peripheral blood mRNA expression of SIRT1 predicted the extent of behavioral despair only when depression-like behavior was induced by juvenile--but not adult--stress, implicating SIRT1 in the regulation of adult behavior at early ages. Consistent with this hypothesis, pharmacological modulation of SIRT1 during juvenile age altered the depression-like behavior in naive mice. We also performed a pilot study in humans, in which the blood levels of SIRT1 correlated significantly with the severity of symptoms in major depression patients, especially in those who received less parental care during childhood. On the basis of these novel findings, we propose the involvement of SIRT1 in the long-term consequences of adverse childhood experiences.

sP-selectin plasma levels in obesity: association with insulin resistance and related metabolic and prothrombotic factors.

BACKGROUND AND AIM: Soluble P-selectin (sP-sel) represents a marker of platelet activation. This study was addressed to investigate the associations of sP-sel plasma levels with anthropometric parameters, insulin resistance, and related metabolic and prothrombotic factors. METHODS AND RESULTS: 50 non-diabetic women, 17 with normal weight and 33 overweight and obese, aged 18-55 years, were examined. Measurements included body mass index (BMI), central fat accumulation (evaluated by waist circumference), systolic and diastolic blood pressure levels, fasting plasma concentrations of sP-sel, glucose, lipids (triglycerides, total cholesterol and HDL-cholesterol), insulin, and prothrombotic factors (plasminogen activator inhibitor-1, von Willebrand factor, fibrinogen), and insulin resistance (estimated by the homeostasis model assessment: HOMA(IR)). Overweight and obese women had higher fasting plasma sP-sel concentrations compared to normal-weight controls (P<0.05). sP-sel concentrations were positively correlated with BMI, HOMA(IR), systolic and diastolic blood pressure, fasting insulin, triglyceride and PAI-1 plasma levels (P<0.05 for all the correlations). When a multiple regression analysis was performed, with P-sel as dependent variable and all the other parameters as independent variables, P-sel did not maintain a significant relationship with any of these variables. CONCLUSIONS: s-P-selectin plasma concentrations are higher in overweight and obese insulin resistant subjects, thus possibly contributing to the cardiovascular risk of these patients. However, body fatness and insulin resistance are not independent determinants of fasting plasma sP-sel concentrations.

MMP-2, MMP-9, VEGF and CA 15.3 in breast cancer.

BACKGROUND: Matrix metalloproteinases (MMPs) are a family of extracellular matrix degrading proteinases. Owing to their matrix-degrading abilities and high expression in advanced tumours, MMPs were originally implicated in cancer progression, invasion and metastasis. PATIENTS AND METHODS: In this study, the correlation was determined between the expression of gelatinases (MMP-2 and MMP-9) in the sera of breast cancer patients from zymographic analysis and serum concentrations of VEGF and CA 15.3, before surgery and after 1 and 6 months; the association of both markers with clinicopathological features including histological type, stage of disease and estrogen (ER) and progesterone (PgR) receptors status were also analysed. In all, 88 breast cancer patients and 20 healthy women were involved in this study. RESULTS: No statistically significant correlation between pro MMP-2, pro MMP-9, VEGF and CA 15.3 serum levels was found (p>0.05). In breast cancer patients, a significant decrease of the pro MMP-2 serum expression 1 month after surgery with respect to serum levels before surgery (p=0.0008) was evident, as well as of CA 15.3 serum levels at baseline and after 1 month (p=0.017). Moreover a strong decrease of pro MMP-9 serum levels was found in 88 breast cancer patients after 1 month (p=0.028) and after 6 months (p =0.009) from surgery. On the other hand, no significant differences in the serum levels of VEGF, CA 15.3, pro MMP-2 or pro MMP-9 between 88 breast cancer patients preoperatively and 20 healthy women as controls were found. Our findings did indicate a significant positive association between higher preoperative levels of CA 15.3 and progression of disease (p=0.03), as well as a longer disease-free survival in patients who exhibited a decrease of serum pro MMP-9 expression compared to other biomarkers. No relationship between these four markers and the main clinical and pathological parameters was found. CONCLUSION: The present study failed to demonstrate any association between serum levels of MMPs, VEGF and CA 15.3 and well-known clinicopathological characteristics of breast carcinoma, while demonstrating the prognostic value of CA 15.3 and pro MMP-9 in the follow-up of breast cancer patients.

MUC3 and MCA serum levels and steroid receptor content in breast cancer.

Mucins are an important class of complex glycoproteins expressed by many epithelial cells and their malignant counterparts. The aim of this study was to determine the serum levels of MUC3 and mucin-like carcinoma-associated antigen (MCA) in patients with primary breast cancer and to analyze the possible relationships between these two mucins and the steroid receptor status. The preoperative basal serum levels of MUC3 (ELISA assay with monoclonal antibody 1143/B7) and MCA (EIA assay with anti-MCA mouse monoclonal antibody b-12) were determined in 44 patients with breast cancer while estrogen receptor (ER) and progesterone receptor (PgR) levels were measured by the dextran-coated charcoal method in the cytosol of neoplastic tissue. MUC3 was expressed in 43/44 serum samples while high MCA serum levels were found in 16/44 only; the mean values of both markers did not correlate with menopausal status, tumor size, nodal involvement or ER. The only significant difference observed was a lower median value of MCA in patients with small tumors (T1-T2). No statistically significant correlation between MUC3 and MCA, MUC3 and ER or MCA and ER was observed; a statistically significant direct correlation between MUC3 and PgR+ status and a statistically significant inverse correlation between MCA and PgR+ were observed. Our results suggest that further investigations are necessary to establish whether progesterone can modulate MUC3 and MCA expression in breast cancer.

Serum vascular endothelial growth factor concentrations in hepatocellular cancer patients undergoing percutaneously radiofrequency thermal ablation.

Vascular endothelial growth factor (VEGF) is known to play a central role in tumour angiogenesis. However, no data have been published with regard to the clinical-biological significance of serum (S)-VEGF in hepatocellular cancer (HCC) patients undergoing to percutaneously radiofrequency thermal ablation (PRFA). The aim of this study was to assess the modifications of S-VEGF levels in a series of 28 HCC patients in hepatitis C virus-positive cirrhosis before and after PRFA, respectively. Samples of S were taken before, 2 and 5 days after PRFA respectively and VEGF levels were assessed by ELISA. No significant difference was found between pre- and post-VEGF levels (p= n.s.; by Wilcoxon test). We suggest that S-VEGF level is not useful as early predictive marker of response to PRFA.

Correlation between HPLC-determined lonidamine serum levels and clinical response in patients with advanced ovarian cancer.

Lonidamine is an energolytic derivative of indazolcarboxilic acid which has been demonstrated to enhance cisplatin activity in ovarian cancer cell lines either sensitive or resistant to this drug, thus suggesting the potential reverting activity of the mechanisms of drug resistance. A study was performed on nine patients with advanced ovarian cancer treated with lonidamine (LND) plus cisplatin (CDDP) as salvage therapy after the failure of first-line platinum containing chemotherapy. Serum LND was determined with a high-performance liquid chromatography (HPLC) method. The objective clinical response included one complete and three partial responses (overall response 44%). High LND serum levels were observed in three of four responding patients. The serum LND concentrations for these patients, detected one hour after the first and second dose administrations, were 15.2 +/- 1.1 and 14.6 +/- 1.4 micrograms/ml, respectively. Toxicity was mild to moderate, except for myalgia. The high serum levels of lonidamine detected in three of four responding patients suggests that the syngerism between LND and CDDP observed ovarian cancer cell lines may be confirmed in clinical practice. However, the potential role of LND in enhancing CDDP activity can be definitely established in large randomized trials.

A prothrombotic state in breast cancer patients treated with adjuvant chemotherapy.

Cancer is often associated with abnormal activation of coagulation leading to a prothrombotic state. Some chemotherapeutic agents used for cancer may induce thrombosis but their biological alterations in the hemostatic system are not yet well understood. This study evaluated alterations of coagulative and fibrinolytic parameters following chemotherapy. In plasma samples of 38 patients (median age: 49 years) receiving CMF (schedule 1-21 or 1-8) for Stage II breast cancer, we evaluated: PT, aPTT, antithrombin III (AT-III), protein C (PC), protein S (PS), thrombin-antithrombin complex (TAT), prothrombin fragment F 1 + 2 (F 1 + 2), fibrinogen (Fbg), tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor (PAI-1) and D-dimer (D-D). PT, aPTT, and Fbg were determined with routine methods; AT-III, PC, and PS were measured with coagulative tests; PC and PS were also evaluated with immunoenzymatic methods, t-PA, PAI-1, D-D, TAT, and F 1 + 2 were measured with immunoenzymatic methods. All tests were performed immediately before starting therapy and after each cycle. A PC antigen decrease appeared soon after beginning therapy and lasted throughout chemotherapy. The lowest values were present after the first treatment both in the CMF 1-21 group (mean +/- SD = 72.5 +/- 10.8%) and in the CMF 1-8 group (mean +/- SD = 77.2 +/- 6.9%): PC activity was also decreased. PS antigen decreased after the first administration (mean +/- SD = 73.3 +/- 10% in CMF 1-21 group, and 72.5 +/- 4.9% in CMF 1-8 group): PS activity also decreased. PAI-1 antigen levels increased (mean +/- SD = 43.1 +/- 20.4 ng/ml in the CMF 1-21 group, and 37.5 +/- 12.2 ng/ml in CMF 1-8 group) lasting up to the last cycle. CMF provokes a trend toward hypercoagulability; this effect should be considered when chemotherapy is employed in advanced cancer patients at high risk for thrombosis, or in patients with other risk factors.

[Blood groups of the ABO system and survival rate in gynecologic tumors]. / Gruppi sanguigni del sistema ABO e sopravvivenza nei tumori ginecologici.

A retrospective analysis of 968 women affected by gynecological tumors was conducted to assess the existence of a difference in survival between patients with different blood groups. Data are presented on 237 cases of endometrial cancer, 92 cases of ovarian cancer and 639 cases of invasive cervix cancer, detailing their ABO blood antigenic phenotypes, the stage of neoplasia and the treatment received. With regard to endometrial cancer, a sensibly better 5-year and 10-year survival is associated with blood group 0 if compared with blood group A. This finding is more evident when 5-year survival is considered among patients affected by ovarian cancer. With regard to cervical cancer, analysis showed that a little better than 5-year survival is associated with 0 blood phenotype; on the contrary, when a 10-year or longer survival is considered, a better survival is associated with A blood phenotype. The present study confirms evidence of an association between the A blood group and gynecological tumors. Endometrial and ovarian cancer occur more frequently in women with blood type A than in those with the other blood types, moreover, in the same tumors blood group A is associated with a poor prognosis. The possible reason for these findings are discussed with detailed regard to the possible biological importance that, at present, is conferred to the ABO group system in the complex activities of the immune system.

Her-2/neu and fibrinolytic factors in human breast-cancer.

HER-2/neu status and t-PA, u-PA, and PAI-1 cytosol content were evaluated in 88 primary breast cancer patients to determine the relationships between these parameters. HER-2/neu was amplified in 24% (20/84) of tumor samples and overexpressed in 28% (14/50). In the overall series, median t-PA, u-PA and PAI-1 contents, measured by the enzyme-linked immmunoassay (ELISA), resulted in 1.7, 1.1 and 1.0 ng/mg cytosol protein (cyt prot), respectively. HER-2/neu overexpressed cases showed higher u-PA levels than those normally expressed whereas t-PA and PAI-1 levels did not vary in HER-2/neu altered and non altered cases. The t-PA levels did not differ in cases with or without HER-2/neu alterations, when separately considering the node-negative and node-positive cases. A significant relationship between t-PA levels and HER-2/neu alterations was observed only in the ER(+) tumors: t-PA levels were lower in amplified and overexpressed cases (1.4 versus 2.5 ng/mg cyt prot in amplified and single copy gene, respectively; 1.6 versus 2.3 ng/mg cyt prot in overexpressed and normally expressed cases, respectively). Therefore, t-PA and HER-2/neu could provide additional prognostic information for ER-negative patients.

Plasma D-dimer measurement as a marker of gynecologic tumors: comparison with Ca 125.

BACKGROUND: Fibrin is formed and degraded intra-abdominally in ovarian cancer, and the cross-linked fibrin degradation product, D-dimer (D-D), has been found in increased concentrations in the plasma of these patients. METHODS: D-dimer and Ca 125 levels were determined simultaneously in 110 patients with gynecologic neoplasms. D-dimer and Ca 125 assays were performed using the Dimertest Stripwell EIA Kit (Ortho) and CA 125-II EIA assay (Roche), respectively. RESULTS: D-dimer plasma and Ca 125 serum levels were significantly higher in patients with ovarian cancer (mean +/- SE = 894.2 +/- 173.7 ng/ml and 760.5 +/- 292.7 U/ml, respectively) than in those with uterine cancer (mean DD +/- SE = 109.7 +/- 23.5 ng/ml and mean Ca 125 +/- SE = 50.0 +/- 23.1 U/ml) or those with benign disease (mean D-D +/- SE = 70.5 +/- 5.5 ng/ml and mean Ca 125 +/- SE = 6.6 +/- 2.8 U/ml). The levels of both markers increased with regard to ovarian cancer disease status. Mean D-D +/- SE was 90.0 +/- 22.8 ng/ml and mean Ca 125 +/- SE was 2.1 +/- 1.2 U/ml in patients with complete remission; mean D-D +/- SE was 143.3 +/- 33.5 ng/ml and mean Ca 125 +/- SE was 26.2 +/- 13.6 U/ml in patients with partial remission. In active disease, both markers had very high levels: D-D mean +/- SE = 1021.6 +/- 173.0 ng/ml and Ca 125 mean +/- SE = 1154.7 +/- 458.1 U/ml. In all groups of ovarian cancer patients, D-dimer sensitivity was better than that of Ca 125. In advanced ovarian cancer patients, the D-dimer concentration in ascites was up to 100 fold that in plasma. CONCLUSIONS: Our results suggest that D-dimer can serve as a sensitive indicator to monitor the extent and course of the disease in ovarian cancer patients. The patient follow-up is ongoing to establish the predictive value of D-dimer measurement with respect to prognosis.

Tissue-type plasminogen activator as marker of functional steroid receptors in human breast cancer.

The relationship between tissue-type plasminogen activator (t-PA) antigen content and receptor status was investigated in 200 human breast cancer cytosols to evaluate the efficacy of t-PA as a marker of functional steroid receptors. t-PA level was measured by an enzyme-linked immunoassay (ELISA) and estrogen (ER) and progesterone (PgR) receptors were assayed by the DCC method. A highly significant correlation was found between t-PA levels and receptor status. The mean +/- SE enzyme content was 13.5 +/- 2.9 in ER+ tumors and 1.8 +/- 0.3 ng/mg protein in ER- tumors; the enzyme content in PgR+ tumors was 14.2 +/- 3.3 and 3.4 +/- 1.4 ng/mg protein in PgR- tumors. When tumors were divided into four subgroups according to receptor content (ER+PgR+, ER+PgR-, ER-PgR+, and ER-PgR-), t-PA concentration was able to differentiate these groups. Also, t-PA level was compared to several clinical variables; it was not correlated with menopausal status or lymph node involvement. However, t-PA content varied according to tumor size. Our data shows that t-PA content in tumor cytosols is statistically related to receptor status and that determination of t-PA levels in breast cancer might furnish additional information as to the functional state of the receptors which may be necessary for planning hormone therapy.

Determination of intraperitoneal mitoxantrone in the serum of cancer patients using a high performance liquid chromatograph coupled to an Advanced Automated Sample Processor (AASP).

A study has been carried out on 10 patients with ovarian cancer treated by intraperitoneal mitoxantrone. The serum concentration was determined by high performance liquid chromatography with spectrophotometric detection. The extracted analyte on the cartridge was injected and eluted on-line into the analytical column by the mobile phase. This improved the signal and sample processing rate, without significant loss in analytical performance. Excellent linearity (r greater than 0.9994) was observed for the calibration curve over the range 1-2000 ng/mL, along with a precision within-day and between-day estimated as 1.5% and 5.6%, respectively. Sensitivity was an order of magnitude higher than that of the comparison method. From a clinical point of view, these preliminary results have shown that intraperitoneal administration is more beneficial than intravenous therapy. Low serum levels (1-30 ng/mL) with a maximum at the first or second hour are revealed.

Measurement of the ovarian cancer-associated antigen CA 125 in monitoring tumor burden and response to chemotherapy.

CA 125 serum levels were measured in 74 patients with ovarian carcinoma. Among 31 patients undergoing a second look laparotomy (SL) after chemotherapy pathologic complete response (PCR) was observed in 14 patients, residual disease (RD) less than 2 cm in 7 patients and RD greater than 2 cm in 10 patients. The disease status was compared to the CA 125 serum levels measured just before SL. Thirteen of the 14 patients with PCR had serum CA 125 values less than 35 U/ml (specificity: 93%). On the other hand, only 10 of the 17 patients with RD showed serum levels greater than 35 U/ml (sensitivity: 59%). Moreover, in the 43 patients receiving chemotherapy, CA 125 levels correlated with the course of the disease in 36 (84%). With regard to early detection of recurrence, in 9/14 patients with PCR, whose CA 125 levels were monitored monthly, by 1 to 7 months an increase of the tumor marker preceded clinical evidence of relapse in 9/9 relapses (100%). In conclusion, CA 125 assay can be helpful in the management of ovarian cancer patients, in monitoring the response to chemotherapy, in the early detection of tumor recurrence, and in predicting the SL findings, although the low sensitivity could be a major drawback in patients with RD before SL.

CA 125 in the monitoring of response to chemotherapy of ovarian carcinoma.

CA 125 serum levels were assessed in 23 patients undergoing chemotherapy for advanced epithelial ovarian carcinoma (EOC). Rising, falling and unchanged levels correlated with disease in 21 out of 23 (95%) cases. Ten out of 11 patients who showed objective response to chemotherapy had a decrease in antigen levels. Two out of 3 patients with stable disease had unchanged values. Progression was always associated with rising levels. CA 125 is a reliable marker for monitoring response to chemotherapy in advanced epithelial ovarian carcinoma.