Preoperative CA125 Significantly Improves Risk Stratification in High-Grade Endometrial Cancer

Patients with high-grade endometrial carcinoma (EC) have an increased risk of tumor spread and lymph node metastasis (LNM). Preoperative imaging and CA125 can be used in work-up. As data on cancer antigen 125 (CA125) in high-grade EC are limited, we aimed to study primarily the predictive value of C...

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Detalles Bibliográficos
Autores: Lombaers, Marike S., Cornel, Karlijn M. C., Visser, Nicole C. M., Bulten, Johan, Küsters-Vandevelde, Heidi V. N, Amant, Frederic, Boll, Dorry, Bronsert, Peter, Colás, Eva, Geomini, Peggy M. A. J., Gil-Moreno, Antonio, van Hamont, Dennis, Huvila, Jutta, Krakstad, Camilla, Kraayenbrink, Arjan A., Koskas, Martin, Mancebo, Gemma, Matias-Guiu, Xavier, Ngo, Huy, Pijlman, Brenda M., Vos, Maria Caroline, Weinberger, Vit, Snijders, Marc P. L. M., van Koeverden, Sebastiaan W, ENITEC-Consortium, Haldorsen, Ingfrid S., Reijnen, Casper, Pijnenborg, Johanna M. A.
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10459.1/464302
Acceso en línea:https://doi.org/10.3390/cancers15092605
https://hdl.handle.net/10459.1/464302
Access Level:acceso abierto
Palabra clave:Endometrial cancer
Advanced stage
Outcome
High-grade
CA125
Descripción
Sumario:Patients with high-grade endometrial carcinoma (EC) have an increased risk of tumor spread and lymph node metastasis (LNM). Preoperative imaging and CA125 can be used in work-up. As data on cancer antigen 125 (CA125) in high-grade EC are limited, we aimed to study primarily the predictive value of CA125, and secondarily the contributive value of computed tomography (CT) for advanced stage and LNM. Patients with high-grade EC (n = 333) and available preoperative CA125 were included retrospectively. The association of CA125 and CT findings with LNM was analyzed by logistic regression. Elevated CA125 ((>35 U/mL), (35.2% (68/193)) was significantly associated with stage III-IV disease (60.3% (41/68)) compared with normal CA125 (20.8% (26/125), [p < 0.001]), and with reduced disease-specific—(DSS) (p < 0.001) and overall survival (OS) (p < 0.001). The overall accuracy of predicting LNM by CT resulted in an area under the curve (AUC) of 0.623 (p < 0.001) independent of CA125. Stratification by CA125 resulted in an AUC of 0.484 (normal), and 0.660 (elevated). In multivariate analysis elevated CA125, non-endometrioid histology, pathological deep myometrial invasion ≥50%, and cervical involvement were significant predictors of LNM, whereas suspected LNM on CT was not. This shows that elevated CA125 is a relevant independent predictor of advanced stage and outcome specifically in high-grade EC.

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