Recent studies have reported that serum cancer antigen (CA) 125 levels may be associated with pathological and survival outcomes in patients with bladder cancer to an extent that may support further investigation of clinical utility as a prognostic biomarker. The limitations of conventional bladder cancer staging prompted our institution to evaluate the association of CA 125 with pathological stage and tumor recurrence after radical cystectomy. Conventionally utilized for the management of ovarian cancer, the ability to detect CA 125 in transitional cell carcinoma tissue and urine of patients with transitional cell carcinoma raises the possibility that bladder cancer may be another indication for such testing. This article evaluates the current literature supporting the role of CA 125 as a biomarker with potential applications in patients with transitional cell carcinoma of the bladder undergoing radical cystectomy and urinary diversion. This article demonstrates that preoperative serum CA 125 levels may serve as a useful predictor of pathological outcomes above grade and stage in patients undergoing cystectomy for urothelial carcinoma of the bladder. The findings also show the potential use of preoperative CA 125 levels to predict unresectable tumors and clarify which candidates should receive neoadjuvant therapy.
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