Folsom Susan M, Mumford Brigid, Lemon Lara, Taylor Sarah
Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, United States.
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, United States.
Gynecol Oncol Rep. 2022 Jun 17;42:101029. doi: 10.1016/j.gore.2022.101029. eCollection 2022 Aug.
CA-125 has long been utilized as a surveillance biomarker for gynecologic malignancies but can be elevated in other conditions, including infection. A study of tumor markers in non-cancer patients saw a rise in CA-125 values during severe COVID-19 infections. Given the potential confounding effect this could have on surveillance and treatment planning, we sought to describe the impact of COVID-19 on CA-125 trends in a gynecologic oncology patient population. We conducted a retrospective chart review of patients treated at a UPMC hospital during the COVID-19 pandemic from March of 2020 through September of 2021. Patients were included for analysis if they had confirmed uterine or ovarian malignancies, a COVID-19 infection and more than one CA-125 value drawn within one year of their COVID-19 diagnosis. The CA-125 values were plotted against the timeline of their COVID-19 infections to assess for trends in CA-125 during and after infection. There were 17 patients who met the above criteria. Of these 17 patients, three had a rise in their CA-125 trend at the time of their COVID-19 diagnosis. Another three had newly elevated CA-125 values, without a prior documented baseline level, at the time of their infection. In all six of these patients, their CA-125 elevations could be attributed to malignancy. The remaining 11 patients showed stable or decreasing CA-125 values coinciding with their COVID-19 infection. This case series illustrates that while CA-125 values may increase during an acute COVID-19 infection, cancer remains the most likely cause of a CA-125 increase. Clinical suspicion should remain high for a possible change in cancer status.
