Abstract
Objective: To evaluate the role of serum CA-125 levels for preoperative counseling in endometrioid endometrial cancer (EEC). Methods: We reviewed 413 patients with EEC from 6 tertiary medical centers between July 1996 and June 2008. All patients were divided into (1) 4 categories of preoperative serum CA-125 levels: < 18 U/mL (n = 203); 18-35 U/mL (n = 114); 36-70 U/mL (n = 53); > 70 U/mL (n = 43) or (2) 3 categories: low-risk (n = 240); intermediate-risk (n = 99); high-risk diseases (n = 74). Results: Receiver operative curves showed the best cut-off values of 16.2-40.8 U/mL for predicting prognostic factors with 53.4-84.2% of sensitivity, 43.9-81.7% of specificity, 48.8-82.1% of positive predictive value (PPV), 48.5-83.8% of negative predictive value (NPV) and 48.6-83.0% of accuracy. Especially, adnexal involvement was predicted with the highest accuracy (83.0%) at ≥ 40.8 U/mL. The best cut-off values for preoperative selection of intermediate- to high-risk, and high-risk diseases were 17.3 U/mL and 21.9 U/mL (62.4% and 68.9% of sensitivity; 54.6% and 64.3% of specificity; 57.9% and 64.2% of PPV; 59.2% and 67.4% of NPV, 58.5% and 65.8% of accuracy). Furthermore, > 70 U/mL of preoperative serum CA-125 levels was a prognostic factor for poor progression-free and overall survivals. Conclusions: Serum CA-125 levels may not be useful for predicting most of prognostic factors, and may not contribute to preoperative selection of patients with intermediate- or high-risk disease who need adjuvant radiotherapy in EEC. However, serum CA-125 levels may be helpful in preoperative counseling for young patients who want ovarian preservation, and > 70 U/mL could be considered as a risk factor for poor survival.
| Original language | English |
|---|---|
| Pages (from-to) | 283-288 |
| Number of pages | 6 |
| Journal | Gynecologic Oncology |
| Volume | 118 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 2010 Sep 1 |
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Keywords
- Endometrioid endometrial cancer
- Preoperative
- Prognostic factors
- Serum CA-125 levels
- Survival
ASJC Scopus subject areas
- Oncology
- Obstetrics and Gynaecology
Cite this
Evaluation of serum CA-125 levels for preoperative counseling in endometrioid endometrial cancer : A multi-center study. / Kim, Hee Seung; Park, Chan Yong; Lee, Jong Min; Lee, Jae Kwan; Cho, Chi Heum; Kim, Seok Mo; Kim, Jae Weon.
In: Gynecologic Oncology, Vol. 118, No. 3, 01.09.2010, p. 283-288.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Evaluation of serum CA-125 levels for preoperative counseling in endometrioid endometrial cancer
T2 - A multi-center study
AU - Kim, Hee Seung
AU - Park, Chan Yong
AU - Lee, Jong Min
AU - Lee, Jae Kwan
AU - Cho, Chi Heum
AU - Kim, Seok Mo
AU - Kim, Jae Weon
PY - 2010/9/1
Y1 - 2010/9/1
N2 - Objective: To evaluate the role of serum CA-125 levels for preoperative counseling in endometrioid endometrial cancer (EEC). Methods: We reviewed 413 patients with EEC from 6 tertiary medical centers between July 1996 and June 2008. All patients were divided into (1) 4 categories of preoperative serum CA-125 levels: < 18 U/mL (n = 203); 18-35 U/mL (n = 114); 36-70 U/mL (n = 53); > 70 U/mL (n = 43) or (2) 3 categories: low-risk (n = 240); intermediate-risk (n = 99); high-risk diseases (n = 74). Results: Receiver operative curves showed the best cut-off values of 16.2-40.8 U/mL for predicting prognostic factors with 53.4-84.2% of sensitivity, 43.9-81.7% of specificity, 48.8-82.1% of positive predictive value (PPV), 48.5-83.8% of negative predictive value (NPV) and 48.6-83.0% of accuracy. Especially, adnexal involvement was predicted with the highest accuracy (83.0%) at ≥ 40.8 U/mL. The best cut-off values for preoperative selection of intermediate- to high-risk, and high-risk diseases were 17.3 U/mL and 21.9 U/mL (62.4% and 68.9% of sensitivity; 54.6% and 64.3% of specificity; 57.9% and 64.2% of PPV; 59.2% and 67.4% of NPV, 58.5% and 65.8% of accuracy). Furthermore, > 70 U/mL of preoperative serum CA-125 levels was a prognostic factor for poor progression-free and overall survivals. Conclusions: Serum CA-125 levels may not be useful for predicting most of prognostic factors, and may not contribute to preoperative selection of patients with intermediate- or high-risk disease who need adjuvant radiotherapy in EEC. However, serum CA-125 levels may be helpful in preoperative counseling for young patients who want ovarian preservation, and > 70 U/mL could be considered as a risk factor for poor survival.
AB - Objective: To evaluate the role of serum CA-125 levels for preoperative counseling in endometrioid endometrial cancer (EEC). Methods: We reviewed 413 patients with EEC from 6 tertiary medical centers between July 1996 and June 2008. All patients were divided into (1) 4 categories of preoperative serum CA-125 levels: < 18 U/mL (n = 203); 18-35 U/mL (n = 114); 36-70 U/mL (n = 53); > 70 U/mL (n = 43) or (2) 3 categories: low-risk (n = 240); intermediate-risk (n = 99); high-risk diseases (n = 74). Results: Receiver operative curves showed the best cut-off values of 16.2-40.8 U/mL for predicting prognostic factors with 53.4-84.2% of sensitivity, 43.9-81.7% of specificity, 48.8-82.1% of positive predictive value (PPV), 48.5-83.8% of negative predictive value (NPV) and 48.6-83.0% of accuracy. Especially, adnexal involvement was predicted with the highest accuracy (83.0%) at ≥ 40.8 U/mL. The best cut-off values for preoperative selection of intermediate- to high-risk, and high-risk diseases were 17.3 U/mL and 21.9 U/mL (62.4% and 68.9% of sensitivity; 54.6% and 64.3% of specificity; 57.9% and 64.2% of PPV; 59.2% and 67.4% of NPV, 58.5% and 65.8% of accuracy). Furthermore, > 70 U/mL of preoperative serum CA-125 levels was a prognostic factor for poor progression-free and overall survivals. Conclusions: Serum CA-125 levels may not be useful for predicting most of prognostic factors, and may not contribute to preoperative selection of patients with intermediate- or high-risk disease who need adjuvant radiotherapy in EEC. However, serum CA-125 levels may be helpful in preoperative counseling for young patients who want ovarian preservation, and > 70 U/mL could be considered as a risk factor for poor survival.
KW - Endometrioid endometrial cancer
KW - Preoperative
KW - Prognostic factors
KW - Serum CA-125 levels
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=77955550569&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77955550569&partnerID=8YFLogxK
U2 - 10.1016/j.ygyno.2010.04.018
DO - 10.1016/j.ygyno.2010.04.018
M3 - Article
C2 - 20541245
AN - SCOPUS:77955550569
VL - 118
SP - 283
EP - 288
JO - Gynecologic Oncology
JF - Gynecologic Oncology
SN - 0090-8258
IS - 3
ER -