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Preoperative CA125 Significantly Improves Risk Stratification in High-Grade Endometrial Cancer
MS. Lombaers, KMC. Cornel, NCM. Visser, J. Bulten, HVN. Küsters-Vandevelde, F. Amant, D. Boll, P. Bronsert, E. Colas, PMAJ. Geomini, A. Gil-Moreno, D. van Hamont, J. Huvila, C. Krakstad, AA. Kraayenbrink, M. Koskas, G. Mancebo, X. Matías-Guiu, H....
Status not-indexed Language English Country Switzerland
Document type Journal Article
NLK
Free Medical Journals
from 2009
PubMed Central
from 2009
Europe PubMed Central
from 2009
ProQuest Central
from 2009-01-01
Open Access Digital Library
from 2009-01-01
Open Access Digital Library
from 2009-01-01
ROAD: Directory of Open Access Scholarly Resources
from 2009
- Publication type
- Journal Article MeSH
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.
Centre for Cancer Biomarkers Department of Clinical Science University of Bergen 5020 Bergen Norway
Department of Gynecology Catharina Hospital 5623 EJ Eindhoven The Netherlands
Department of Obstetrics and Gynaecology Rijnstate Hospital 6815 AD Arnhem The Netherlands
Department of Obstetrics and Gynecology Amphia Hospital Breda 4818 CK Breda The Netherlands
Department of Obstetrics and Gynecology Bichat Claude Bernard Hospital 75018 Paris France
Department of Obstetrics and Gynecology Elkerliek Hospital 5751 CB Helmond The Netherlands
Department of Obstetrics and Gynecology Haukeland University Hospital 5021 Bergen Norway
Department of Obstetrics and Gynecology Hospital del Mar Parc de Salut Mar 08003 Barcelona Spain
Department of Obstetrics and Gynecology Maxima Medical Centre 5631 BM Veldhoven The Netherlands
Department of Oncology KU Leuven 3000 Leuven Belgium
Department of Pathology Canisius Wilhelmina Hospital 6532 SZ Nijmegen The Netherlands
Department of Pathology Eurofins PAMM 5623 EJ Eindhoven The Netherlands
Department of Pathology Radboud University Medical Center 6525 GA Nijmegen The Netherlands
Department of Pathology University of Turku 20500 Turku Finland
Department of Radiation Oncology Radboud University Medical Center 6525 GA Nijmegen The Netherlands
Institute of Pathology University Medical Center 79104 Freiburg Germany
Radboud Institute of Health Sciences 6525 GA Nijmegen The Netherlands
References provided by Crossref.org
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