Prolonged symptom-free survival in a patient with persistent primary peritoneal carcinoma and a rising CA-125: a note of caution
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1Cleveland Clinic Taussig Cancer Center, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
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.