Serial serum CA 125 measurements for evaluation of recurrence in patients with endometrial carcinoma.
OBJECTIVE
To evaluate the usefulness of serum assays for CA 125 to detect recurrent endometrial carcinoma.


METHODS
Two hundred sixty-six patients were studied with 1101 post-treatment assays. Patients were categorized as low, medium, or high risk based on surgical-pathologic findings. CA 125 values were analyzed with respect to each patient's disease status.


RESULTS
Serial CA 125 levels were elevated (greater than 35 U/mL) in 19 of 33 patients (58%) with recurrent disease. Among 236 surgically treated patients, 97 (41.1%), 42 (17.8%), and 97 (41.1%) were considered low, medium, and high risk, respectively. None of the low-risk and only two (4.7%) of the medium-risk patients developed recurrent disease. One of the latter patients was detected based on an elevated CA 125 level alone. Twenty-seven (27.8%) of the high-risk patients developed recurrent disease, 23 of whom had elevated pre-treatment CA 125. Fifteen of 16 (94%) with recurrent disease had an elevated CA 125 level. Nine of 12 patients with papillary serous carcinoma experienced recurrence; eight of these nine had elevated CA 125 levels at diagnosis and recurrence, in contrast to only one patient with a normal pre-treatment level (P = .018). False elevations were noted in 13 patients, 12 of whom had received radiation therapy.


CONCLUSIONS
CA 125, if elevated at diagnosis of endometrial carcinoma, is an important marker for recurrent disease. The use of serial CA 125 assays is most beneficial in diagnosing recurrence in a high-risk population, including patients with papillary serous carcinomas. False elevations may occur following radiation therapy.
Rose
P G
PG
Department of Obstetrics and Gynecology, University of Massachusetts Medical School, Worcester.
Sommers
R M
RM
Reale
F R
FR
Hunter
R E
RE
Fournier
L
L
Nelson
B E
BE
D018262:Adenocarcinoma, Clear Cell / Q000097:blood* / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood*; D003131:Combined Modality Therapy; D018292:Cystadenoma, Papillary / Q000097:blood* / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D016889:Endometrial Neoplasms / Q000097:blood* / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D005189:False Positive Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D009364:Neoplasm Recurrence, Local / Q000097:blood* / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D011159:Population Surveillance / Q000379:methods*; D011379:Prognosis; D015203:Reproducibility of Results; D012307:Risk Factors; D016896:Treatment Outcome
D015295:Antigens, Tumor-Associated, Carbohydrate