Preoperative CA125 significantly improves risk stratification in high-Grade endometrial cancer

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• dc.contributor.author Lombaers, Marike S.
• dc.contributor.author Mancebo Moreno, Gemma
• dc.contributor.author Pijnenborg, Johanna M.A.
• dc.date.accessioned 2024-02-28T08:03:03Z
• dc.date.available 2024-02-28T08:03:03Z
• dc.date.issued 2023
• dc.description.abstract 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.
• dc.format.mimetype application/pdf
• dc.identifier.citation Lombaers MS, Cornel KMC, Visser NCM, Bulten J, Küsters-Vandevelde HVN, Amant F et al. Preoperative CA125 significantly improves risk stratification in high-Grade endometrial cancer. Cancers (Basel). 2023 May 4;15(9):2605. DOI: 10.3390/cancers15092605
• dc.identifier.doi http://dx.doi.org/10.3390/cancers15092605
• dc.identifier.issn 2072-6694
• dc.identifier.uri http://hdl.handle.net/10230/59271
• dc.language.iso eng
• dc.publisher MDPI
• dc.relation.ispartof Cancers (Basel). 2023 May 4;15(9):2605
• dc.rights © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword CA125
• dc.subject.keyword Advanced stage
• dc.subject.keyword Endometrial cancer
• dc.subject.keyword High-grade
• dc.subject.keyword Outcome
• dc.title Preoperative CA125 significantly improves risk stratification in high-Grade endometrial cancer
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion