Evaluation of serum CA-125 levels for preoperative counseling in endometrioid endometrial cancer

A multi-center study

Hee Seung Kim, Chan Yong Park, Jong Min Lee, Jae Kwan Lee, Chi Heum Cho, Seok Mo Kim, Jae Weon Kim

Research output: Contribution to journalArticle

31 Citations (Scopus)

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 languageEnglish
Pages (from-to)283-288
Number of pages6
JournalGynecologic Oncology
Volume118
Issue number3
DOIs
Publication statusPublished - 2010 Sep 1

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Endometrial Neoplasms
Counseling
Serum
Adjuvant Radiotherapy
Patient Selection
Disease-Free Survival
Survival

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 journalArticle

Kim, Hee Seung ; Park, Chan Yong ; Lee, Jong Min ; Lee, Jae Kwan ; Cho, Chi Heum ; Kim, Seok Mo ; Kim, Jae Weon. / Evaluation of serum CA-125 levels for preoperative counseling in endometrioid endometrial cancer : A multi-center study. In: Gynecologic Oncology. 2010 ; Vol. 118, No. 3. pp. 283-288.
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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.",
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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

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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.

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KW - Preoperative

KW - Prognostic factors

KW - Serum CA-125 levels

KW - Survival

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