Preoperative CA-125, CA 19-9 and nuclear magnetic resonance in endometrial carcinoma: correlation with surgical stage

Serum CA 125 and CA 19-9 determinations and nuclear magnetic resonance (NMR) of the pelvis were performed in 100 consecutive endometrial carcinoma patients, who were surgically staged afterwards. The aim was to assess the value of these combined studies to predict the surgical stage of endometrial carcinoma. The results were correlated with the final surgical stage. NMR or elevated tumor marker values alone were able to predict a surgical stage equal to or higher than IC in 84.6 and 78.8% of the cases, respectively. The combination of both procedures yielded better positive and negative predictive values (90.9 and 88%, respectively), but only when both were concordant (p < 0.0001). When only one of them suggested a higher stage (28% of the cases), the positive predictive value decreased to 70.4%. The accuracy in predicting a higher surgical stage in endometrial carcinoma by preoperative noninvasive means is slightly improved when combining NMR and serum tumor marker determinations. The predictive value, however, is not absolute and clearly unsatisfactory in 28% of the cases.