Value of serum 125Ca levels: does the result preclude second look?

Forty-five women with known histories of ovarian cancer underwent reoperative surgery. Thirty-seven patients underwent routine second-look laparotomy and eight patients were reexplored with clinical evidence of disease with the intent of re-resection. Preoperative CA 125 levels were obtained. Evaluation as to the predictive value of the CA 125 level and operative findings show a positive predictive value of 100% and a negative predictive value of 54%. Twenty of the forty-five patients had gross disease present on reoperation. Twenty patients were found to have persistent disease at reoperation. Twenty-five percent of patients with CA 125 levels less than or equal to 35 U/ml and 37% of these with CA 125 levels greater than 35 U/ml were resectable to no gross disease at the completion of the reoperation. CA 125 levels greater than or less than 35 U/ml were not predictive of the potential for re-resectability of the tumor.