The prognostic role of preoperative serum CA125 levels in patients with advanced endometrial carcinoma

Modarres-Gilani, Mitra; Vaezi, Maryam; Shariat, Mamak; Zamani, Narges; Nourizadeh, Roghaiyeh

doi:10.3233/cbm-160529

Cited by 16 publications

(15 citation statements)

References 27 publications

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“…Based on the study of Modarres-Gilani et al from Iran on 91 cases with endometrial cancer in 2017, in line with our results, high preoperative CA125 was significantly correlated with advanced stage (cut-off value: 20 u/mL) (18). Also, they found a significant correlation between depth of myometrial invasion and CA125 level, but our study did not demonstrate this association.…”

Section: Discussionsupporting

confidence: 88%

The Prognostic Value of Preoperative Serum CA125 in Endometrioid Endometrial Cancer with Cervical Stromal and Parametrial Invasion

et al. 2019

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Background: Although endometrial cancer is not ranked among the ten most common cancer types in Iran, it is the 12th most prevalent in women and the third most common cancer of the female genital tract after breast and ovarian cancer. The mortality rate of endometrial cancer in Iran is 0.6 in 100,000 persons. Several studies have evaluated the correlation of preoperative CA125 in endometrial cancer with several surgicopathologic and prognostic variables, disease recurrence, and the need for lymphadenectomy. Recent data have suggested adjuvant extrafascial hysterectomy after neoadjuvant therapy instead of the initial radical hysterectomy for locally advanced disease. Therefore, it would be helpful to use a preoperative assessment, including serum CA125 measurement to predict the extent of the disease and plan a less complicated therapy. Objectives: To evaluate the cutoff value of CA125 in parametrial and cervical stromal invasion of endometrioid endometrial cancer. Methods: A sample of 128 endometrial cancer cases, surgically staged from 2012 to 2018 in Imam Hossein Hospital were evaluated. According to the exclusion criteria, 82 cases were finally analyzed. A receiver operating characteristic (ROC) curve was used to determine the cutoff value of preoperative CA125 for parametrial and cervical stromal involvement. Results: A high preoperative CA125 level was significantly associated with advanced disease stage, cervical stromal invasion, pelvic lymph node metastases, and higher grade (P < 0.05); the test showed a marginally significant correlation for parametrial invasion, which may be due to sample size limitation (P = 0.058). However, the correlation between CA125 and myometrial/lymphovascular invasions were not statistically significant (P = 0.112 and P = 0.168, respectively). The optimal cutoff value for preoperative CA125 was 45.5 u/mL in parametrial invasion (100% sensitivity, 89% specificity, 33.3% positive predictive value, and 100% negative predictive value), and 41.9 u/mL for cervical stromal invasion (87.5% sensitivity, 87.8% specificity, 43.75% positive predictive value, and 98.48% negative predictive value). Conclusions: Primary radical surgery may not be the first treatment approach in cervical/parametrial involvement. Neoadjuvant (chemo)radiotherapy and adjuvant extrafascial hysterectomy could be an alternative approach with fewer complications. Using preoperative CA125 along with physical examination and imaging modalities would be helpful in this regard. More investigations are needed to assess an agreed cutoff value for preoperative CA125 and endometrial cancer extension.

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Section: Discussionsupporting

confidence: 88%

The Prognostic Value of Preoperative Serum CA125 in Endometrioid Endometrial Cancer with Cervical Stromal and Parametrial Invasion

et al. 2019

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“…To compare the diagnostic value of the studied AFs with biomarkers that are in clinical use, we compared the ROC curves for sTie-2, G-CSF, and leptin with those for CA-125 and HE4. CA-125 and HE4 have been extensively studied in ovarian and EC, and their diagnostic and prognostic values in gynecological cancers have been reported [16,[55][56][57]. This comparison revealed that sTie-2, G-CSF, and leptin have similar AUC values as CA-125 and HE4 for the separation of EC and control patients.…”

Section: Discussionmentioning

confidence: 84%

Tie-2, G-CSF, and Leptin as Promising Diagnostic Biomarkers for Endometrial Cancer: A Pilot Study

Roškar

Klančič

Knific

et al. 2021

JCM

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Preoperative determination of the extent of endometrial cancer (EC) would avoid the complications associated with radical surgery. Screening of patients’ plasma biomarkers might enable a more precise diagnosis of EC and a tailored treatment approach. This prospective case-control monocentric pilot study included 76 postmenopausal women (38 endometrioid EC patients and 38 control patients with benign gynecological conditions), and 37 angiogenic factors (AFs) were investigated as potential biomarkers for EC. AF concentrations in preoperative plasma samples were measured using Luminex xMAP™ multiplexing technology. The plasma levels of sTie-2 and G-CSF were significantly lower in EC compared to control patients, whereas the plasma levels of leptin were significantly higher in EC patients. Neuropilin-1 plasma levels were significantly higher in patients with type 2 EC (grade 3) compared to patients with lower grade cancer or controls. Follistatin levels were significantly higher in patients with lymphovascular invasion, and IL-8 plasma levels were significantly higher in patients with metastases. If validated, the plasma concentrations of the indicated AFs could represent an important additional diagnostic tool for the early detection and characterization of EC. This could guide the decision-making on the extent of surgery. Further studies with larger patient numbers are currently ongoing.

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“…The identi cation and use of biomarkers for EC is an active area of research [12][13][14][15]. Serum level of CA125 has been described as an effective tumor biomarker for EC patients [17][18][19][20]. However, its use in the pre-operative assessment of EC patients remains controversial and has not been studied in depth [21].…”

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Preoperative Serum CA125, CA19-9, CA72-4, CEA, and AFP in Patients With Endometrial Cancer

Wang¹,

Zhang²,

Wu³

et al. 2021

Preprint

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Objective: To determine the factors related to overall survival (OS) and progression-free survival (PFS) in endometrial cancer (EC) patients.Materials and methods: A retrospective cohort study of 906 EC patients was conducted at Shengjing Hospital, China Medical University. Baseline information about the patients, tumor characteristics, and data on five serum biomarkers (CA125, CA19-9, CA72-4, CEA, and AFP) were collected. Groups and their survival rates were compared using log-rank tests and Kaplan-Meier analysis, respectively. Hazard ratios (HRs) and 95% confidence intervals (CIs) were determined using univariate or multivariate Cox proportional hazard models. The outcome measures used were OS, defined as the time between surgery and death or last follow-up for surviving patients, and PFS, defined as the time from the completion of initial surgery to either first progression, disease recurrence, or death.Results: Multivariate analysis showed lower PFS associated with age ≥ 66 years (P < 0.001), type II histology (P = 0.015), low degree of tumor differentiation (P = 0.004), and FIGO stage III & IV (P = 0.002). Elevated CA125 (P = 0.042) and AFP (P = 0.016) were identified as independent biomarkers for PFS. Increased CA125 (P = 0.013), age ≥ 66 years (P < 0.001), type II histology (P＜0.001), and FIGO stage III & IV (P = 0.015) were independent factors associated with OS. Analysis of the CA125 sub-group showed that individuals with elevated CA125 andAFP (P = 0.049) had significantly lower PFS. Conclusion: This study suggests that CA125 and AFP are prognostic biomarkers for EC.

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The prognostic role of preoperative serum CA125 levels in patients with advanced endometrial carcinoma

Cited by 16 publications

References 27 publications

The Prognostic Value of Preoperative Serum CA125 in Endometrioid Endometrial Cancer with Cervical Stromal and Parametrial Invasion

The Prognostic Value of Preoperative Serum CA125 in Endometrioid Endometrial Cancer with Cervical Stromal and Parametrial Invasion

Tie-2, G-CSF, and Leptin as Promising Diagnostic Biomarkers for Endometrial Cancer: A Pilot Study

Prognostic Significance of Preoperative Serum CA125, CA19-9, CA72-4, CEA, and AFP in Patients With Endometrial Cancer

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The prognostic role of preoperative serum CA125 levels in patients with advanced endometrial carcinoma

Cited by 16 publications

References 27 publications

The Prognostic Value of Preoperative Serum CA125 in Endometrioid Endometrial Cancer with Cervical Stromal and Parametrial Invasion

The Prognostic Value of Preoperative Serum CA125 in Endometrioid Endometrial Cancer with Cervical Stromal and Parametrial Invasion

Tie-2, G-CSF, and Leptin as Promising Diagnostic Biomarkers for Endometrial Cancer: A Pilot Study

Prognostic Significance of Preoperative Serum CA125, CA19-9, CA72-4, CEA, and AFP&nbsp;in Patients With Endometrial Cancer

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Prognostic Significance of Preoperative Serum CA125, CA19-9, CA72-4, CEA, and AFP in Patients With Endometrial Cancer