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Preoperative CA 125 tumour marker in endometrial cancer: correlation with advanced stage disease
Alexandra Sebastianelli1, Marie-Claude Renaud1, Jean Grégoire1
1Department of Gynecologic Oncology, Centre Hospitalier Universitaire de Québec, pavillon Hôtel-Dieu de Québec, Quebec City QC.
Objective:
To evaluate if a preoperative serum CA 125 level>or=35 kU/L in patients with endometrial cancer correlates with a surgical stage III or IV and poor histopathological prognostic factors.
Methods:
We conducted a retrospective cohort study of 254 patients who underwent hysterectomy and full staging for endometrial cancer. Preoperative serum CA 125 was available for each patient as well as complete clinical and histopathological data. Chi-square, Fisher exact test, multivariate logistic regression, and receiver operating characteristic curve curves were used for statistical analysis.
Results:
A total of 186 (73%) patients had stage I or II disease and 68 (27%) had stage III or IV disease. A statistically higher number of patients from the stage III or IV group had a serum CA 125 level>or=35 kU/L (58%) compared with the stage I or II group (16%) (OR 7.44; P<0.001). There was no correlation between serum CA 125 level and histological subtype. Patients with stage I or II disease and serum CA 125>or=35 kU/L (46%) had significantly more frequent deep myometrial invasion (>50%) than did those with serum CA 125<35 kU/L (18%) (OR 3.68; P=0.006).
Conclusion:
Assay of the preoperative serum CA 125 level is a very simple test to detect patients with more advanced stage endometrial adenocarcinoma. Its routine use could help triage high risk patients preoperatively.