[Potential value of CA125 kinetic monitoring in the initial management of advanced epithelial ovarian cancer]. / Intérêt potentiel du suivi de cinétique du CA125 dans la prise en charge initiale des cancers épithéliaux de l'ovaire de stade avancé

ABSTRACT

Ovarian carcinoma is account for 4% of all women cancer deaths because of late diagnosis at advanced stage. During chemotherapy, survey includes repeated assays of antigen carbohydrate 125 (CA125), which is a membrane glycoprotein belonging to the mucin family and secreted by 80% of the serous ovarian tumours. The aim of this study was to analyze the clinical relevance of a follow-up of CA125 kinetics of five ovarian carcinoma patients at advanced stages and under neoadjuvant chemotherapy. CA125 was assayed on a Kryptor(®) (Thermo-Fisher BRAHMS) and CA125 kinetics on semi-logarithmic curve with the software "Cinetic System". This software calculates the half-life and the doubling time between two points and can detect a line of tendency. It can also point out the nadir value. Kinetics are followed during 1 or 2 years. For all patients, we observe a very good agreement between kinetics, clinical and radiological issues (tumor size reduction). For three patients, after the first chemotherapy, the lines of tendency are decreasing. In one case with peritoneal carcinomatosis, the retrospective study of the pattern showed a biphasic curve anticipating the radiological modifications. For the two other patients, the normalisation of the CA125 is never obtained with no possible surgery. A greatest study could confirm the interest of associating this graphic approach to the clinical and radiological elements in order to optimize the medico-surgical assumption of responsibility of these patients with ovarian carcinoma at advanced stages, under first adjuvant treatment.