Predictive value of preoperative serum CA 125 levels in clinically localized and advanced endometrial carcinoma

Serum CA 125 levels were measured preoperatively by standard radioimmunometric techniques in 89 patients with primary endometrial carcinoma before definitive surgical staging and resection. Fifty-seven of 58 (98%) patients with clinical and surgical Stage I or II disease had normal preoperative serum CA 125 levels. All eight patients with clinically advanced endometrial cancer (International Federation of Gynecology and Obstetrics Stage III or IV) had elevated CA 125 levels before surgery. Twenty of 23 patients (87%) with clinical Stage I or II endometrial cancer who were found to have extrauterine spread of disease during staging laparotomy had elevated preoperative serum CA 125 levels. Thus preoperative CA 125 levels were elevated in 28 of 31 patients (90.3%) with surgically staged endometrial adenocarcinoma with extrauterine disease and may play a useful role in detecting those patients with clinically localized endometrial cancer who have occult extrauterine spread of disease.