Use of preoperative serum CA-125 levels for prediction of lymph node metastasis and prognosis in endometrial cancer.
BACKGROUND
The purpose of this study was to evaluate the predictive value of preoperative serum CA-125 levels in the assessment of disease extent and clinical outcome of endometrial cancer.


METHODS
This retrospective study evaluated 92 women with pathologically proven endometrial carcinoma scheduled for treatment that had preoperative serum CA-125 levels between January 1999 and February 2006. The association of preoperative serum CA-125 with a variety of histopathologic factors was evaluated. Statistical analysis was performed using chi2/Fisher's exact test and a logistic regression. Survival was studied with the Kaplan-Meier method and Cox regression models.


RESULTS
Elevated serum CA-125 levels were significantly correlated with advanced-stage disease (p<0.001), lymph node metastases (p<0.001), increased depth of myometrial invasion (p=0.001), and positive peritoneal cytology (p=0.026). Multivariate analyses using logistic regression showed that lymph node metastases had the most significant effect on the elevation of preoperative serum CA-125 levels (p=0.004). Patients with a serum CA-125 < or =28.5 U/ml had a significantly better five-year disease-free survival than those with an elevated level in this study: 85.6% versus 60.0% (p=0.004).


CONCLUSIONS
The preoperative serum CA-125 level appears to be a significant independent predictor of lymph node metastasis and prognosis after surgical intervention. Therefore, preoperative serum CA-125 may be a useful tool, in the clinical setting, for optimal individualized patient management.
Chung
Hyun Hoon
HH
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea.
Kim
Jae Weon
JW
Park
Noh-Hyun
NH
Song
Yong-Sang
YS
Kang
Soon-Beom
SB
Lee
Hyo-Pyo
HP
D018394:CA-125 Antigen / Q000097:blood*; D018269:Carcinoma, Endometrioid / Q000097:blood* / Q000556:secondary* / Q000601:surgery; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000097:blood* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D016015:Logistic Models; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000175:diagnosis / Q000473:pathology; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D018394:CA-125 Antigen