Serum CA125 predicts extrauterine disease and survival in uterine carcinosarcoma.
OBJECTIVE
The purpose of this study was to determine the clinical utility of CA125 measurement in patients with uterine carcinosarcoma (CS).


METHODS
Ninety-five consecutive patients treated for CS at a single institution were identified. All 54 patients who underwent preoperative CA125 measurement were included in the study. Data were abstracted from the medical records. Tests of association between preoperative CA125 and previously identified clinicopathologic prognostic factors were performed using Fisher's exact test and Pearson chi-square test. To evaluate the relationship of CA125 elevation and survival, a Cox proportional hazard model was used for multivariate analysis, incorporating all of the prognostic factors identified by univariate analysis.


RESULTS
Preoperative CA125 was significantly associated with the presence of extrauterine disease (P<0.001), deep myometrial invasion (P<0.001), and serous histology of the epithelial component (P=0.005). Using univariate survival analysis, stage (HR=1.808, P=0.004), postoperative CA125 level (HR=9.855, P<0.001), and estrogen receptor positivity (HR=0.314, P=0.029) were significantly associated with survival. In the multivariate model, only postoperative CA125 level remained significantly associated with poor survival (HR=5.725, P=0.009).


CONCLUSIONS
Preoperative CA125 elevation is a marker of extrauterine disease and deep myometrial invasion in patients with uterine CS. Postoperative CA125 elevation is an independent prognostic factor for poor survival. These findings indicate that CA125 may be a clinically useful serum marker in the management of patients with CS.
Huang
Gloria S
GS
Department of Obstetrics and Gynecology and Women's Health, Division of Gynecologic Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York 10461, USA. ghuang@montefiore.org
Chiu
Lydia G
LG
Gebb
Juliana S
JS
Gunter
Marc J
MJ
Sukumvanich
Paniti
P
Goldberg
Gary L
GL
Einstein
Mark H
MH
D000368:Aged; D018394:CA-125 Antigen / Q000097:blood*; D002296:Carcinosarcoma / Q000097:blood* / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009215:Myometrium / Q000473:pathology; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D015996:Survival Rate; D014594:Uterine Neoplasms / Q000097:blood* / Q000473:pathology*
D018394:CA-125 Antigen