Value of pre-operative serum CA125 level for prediction of prognosis in patients with endometrial cancer

Aust N Z J Obstet Gynaecol. 2011 Oct;51(5):397-402. doi: 10.1111/j.1479-828X.2011.01325.x. Epub 2011 Jun 9.

Abstract

Background: High pre-operative CA125 levels in women with endometrial cancer may be related to lymph node metastases and poor prognosis.

Aim: To evaluate whether pre-operative cancer antigen 125 (CA125) levels are associated with lymph node metastases and prognosis in endometrial cancer.

Methods: One hundred and twenty women with endometrial cancer were retrospectively reviewed for pre-operative CA125 levels. The results were then correlated with the clinicopathological outcome.

Results: An elevated CA125 (>40 U/mL) was significantly correlated with higher stage, higher grade, increased depth of myometrial invasion, lymph node metastases and the presence of lympho-vascular space involvement in endometrial cancer. Five-year overall survival (OS) and recurrence-free survival (RFS) rates were significantly higher in women with endometrial cancer with CA125 ≤ 40 U/mL than those with CA125 > 40 U/mL (P < 0.001). When women were further stratified according to CA125 levels and lymph node status, OS and RFS were highest for those with CA125 ≤ 40 U/mL and without lymph node metastases, and lowest for those with lymph node metastases and CA125 > 40 U/mL (P < 0.001).

Conclusion: The testing of pre-operative CA125 levels may a useful prognostic tool in endometrial cancer management.

MeSH terms

  • Adult
  • Aged
  • CA-125 Antigen / blood*
  • Carcinoma / blood*
  • Carcinoma / secondary*
  • Carcinoma / surgery
  • Disease-Free Survival
  • Endometrial Neoplasms / blood*
  • Endometrial Neoplasms / pathology*
  • Endometrial Neoplasms / surgery
  • Female
  • Humans
  • Hysterectomy
  • Kaplan-Meier Estimate
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Predictive Value of Tests
  • Preoperative Period
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies

Substances

  • CA-125 Antigen