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Serum CA 125 is an independent prognostic factor in cervical adenocarcinoma
David P Bender1, Joel I Sorosky, Richard E Buller
1Department of Obstetrics and Gynecology, Holden Comprehensive Cancer Center, University of Iowa Hospitals and Clinics, USA.
Objective:
The purpose of this study was to determine the prognostic significance of a pretreatment serum CA 125 value in patients who were diagnosed with adenocarcinoma of the cervix.
Study Design:
All patients who were diagnosed with adenocarcinoma or adenosquamous carcinoma of the cervix and treated definitively between 1986 and 1998 were eligible. The relationship between pretreatment serum CA 125 values and various clinical factors was evaluated.
Results:
Seventy-three patients had pretreatment CA 125 drawn, with values that ranged from 5 to 683 U/mL and all patients were included in this study. A CA 125 value of >or=30 U/mL was defined as elevated by the receiver operating characteristic curve analysis and used for all subsequent analyses. Elevated serum CA 125 values were identified in 33% of the 73 patients. On the basis of the univariate analyses, an elevated pretreatment CA 125 value was associated significantly with advanced International Federation of Gynecology and Obstetrics stage (>IIA, P =.01), high grade (2 or 3, P =.04), tumor diameter >4 cm (P <.01), and positive pelvic or para-aortic lymph nodes (P =.002). The median survival time was 2.8 years for patients with a pretreatment CA 125 value of >or=30 U/mL and not yet reached for patients with values of <30 U/mL(P <.001). Pretreatment clinical variables that included CA 125 value, age, stage, grade, and tumor diameter were evaluated in a Cox proportional hazards model, and an elevated CA 125 value was the most significant predictor of survival (P <.001).
Conclusion:
Serum CA 125 is an independent prognostic marker for patients with cervical adenocarcinoma.