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Forum Name: Ovarian Cancer

Question: further CA125 drop.CT scan-Lymph node became necrotic and


 indrasis - Wed Apr 08, 2009 3:48 am

My mother was diagonised clear cell OVCA in march 06 (Total Hysterectomy + 6 cycles of cisplatin +Taxol) had suffered recurrences in Dec 2007 in Omentum (Dissected and chemotherapy with liposmal dixrubicin + Cyclophosphamide) and September 08 ( One 3cmx2.5 cm lymph node at paraaortic region) Her CA went up to 537 and this is the first time her CA crossed 150 during 3 years.

After so many options like opn,alternative teatment for just one Lymph node we emphasized another round of chemo and She received 3 cyles of Carbo+Gemzar so far and Her CA 125 was 138 after 2nd cycle and It is 85 after 25 days of 3rd cycle.

Latest CT scan report shows one necrotic lymph node with a reduced size 3.1cmx2cmx2cm compared to 3.44cmx4cmx2.77cm in dec,08.
Doctros are happy to see the progress and now would not like to go for surgery but further 1/2 cycles of chemo.
My question is What Does Necrotic node indicate (Is it good or bad)? And what should be the treatment mode from now on? Heard that isolated lymphnodes have better prognosis factor. can it be applicable for the above scenario? Please Advise.
P.S :She is taking admission on 10th of april for 4th cycle.
 Dr. Tamer Fouad - Thu Apr 09, 2009 10:45 am

User avatar Hello,

I'm sorry to hear about your mother's condition. Clear cell ovarian cancer is associated with a less favorable outcome, which would explain why your mother has had to go through several lines of chemotherapy. Clear cell carcinomas also tend to be more resistant to platinum and taxanes. This may explain the excellent response she is having with Gemzar.

A necrotic lymph node is a good thing. What necrosis means is dead tissue. This is due to cells (mostly cancer cells) dying due to the effect of therapy.

One really cannot determine the course of therapy from now on. Since it depends on many things including how well she will respond to her current rounds of chemotherapy and how long this duration will last. If for some reason she does develop a recurrence, the location and presentation of the recurrence is also very important.

CA 125 is very sensitive for follow up of therapy in advanced ovarian cancer and actually may predate clinical progression by approximately 6 months.

Best wishes for a complete recovery.

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