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This study aimed to clarify the association between a biochemical relapse (only the elevation of CA125) and an image-identified relapse to predict the relapsed lesions better. 162 patients who achieved complete clinical response were enrolled from women diagnosed with stage I-IV serous ovarian, tubal, and peritoneal cancers from January 2013 to June 2019 at our center. The CA125 level of 2\u2009\u00d7\u2009nadir was defined as the indicator of image-identified relapse (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Compared to CA125 level exceeding 35 U\/ml, the 2\u2009\u00d7\u2009nadir of CA125 improve the sensitivity of image-identified relapse (84.9% vs 67.4%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001); the 2\u2009\u00d7\u2009nadir value can act as an earlier warning relapse signal with a longer median time to image-identified relapse (2.7 vs. 0\u00a0months,<jats:italic> P<\/jats:italic>\u2009&lt;\u20090.001). Of the relapsed population, there was no difference of CA125 changing trend between the neoadjuvant chemotherapy (NACT) and primary debulking surgery (PDS) group after initial treatment. Compared with 35 U\/ml, CA125 reaching 2\u2009\u00d7\u2009nadir during the follow-up process might be a more sensitive and early relapse signal in patients with serous OvCa. This criterion may help guide patients to be recommended for imaging examination to detect potential relapse in time.<\/jats:p>","DOI":"10.1038\/s41598-024-65760-4","type":"journal-article","created":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T19:01:55Z","timestamp":1719860515000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["An increase of serum CA-125 to two times of nadir level strongly predicts the image-identified relapse of serous ovarian cancer"],"prefix":"10.1038","volume":"14","author":[{"given":"Kaiwen","family":"Du","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qian","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David Wai","family":"Chan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinjin","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoxia","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanjie","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junying","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiyu","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,7,1]]},"reference":[{"key":"65760_CR1","unstructured":"Title of Cancer Stat Facts: Ovarian Cancer. 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