Improved preoperative risk stratification with CA-125 in low-grade endometrial cancer: a multicenter prospective cohort study.
Biomarkers
CA-125 Antigen
Endometrial Neoplasms
Low-grade Carcinoma
Risk Stratification
Journal
Journal of gynecologic oncology
ISSN: 2005-0399
Titre abrégé: J Gynecol Oncol
Pays: Korea (South)
ID NLM: 101483150
Informations de publication
Date de publication:
Sep 2019
Sep 2019
Historique:
received:
02
01
2019
revised:
30
01
2019
accepted:
24
02
2019
entrez:
23
7
2019
pubmed:
23
7
2019
medline:
11
4
2020
Statut:
ppublish
Résumé
The global obesity epidemic has great impact on the prevalence of low-grade endometrial carcinoma. The preoperative tumor serum marker cancer antigen 125 (CA-125) might contribute to improved identification of high-risk patients within this group. The study aimed to investigate the prognostic value of CA-125 in relation to established preoperative prognosticators, with a focus on identifying patients with poor outcome in low-grade endometrial carcinoma (EC) patients. Prospective multicenter cohort study including all consecutive patients surgically treated for endometrial carcinoma in nine collaborating hospitals from September 2011 until December 2013. All preoperative histopathological diagnoses were reviewed in a blinded manner. Associations between CA-125 and clinicopathological features were determined. Univariable and multivariable analysis by Cox regression were used. Separate analyses were performed for preoperatively designated low-grade and high-grade endometrial carcinoma patients. A total of 333 patients were analyzed. CA-125 was associated with poor prognostic features including advanced International Federation of Gynecology and Obstetrics (FIGO) stage. In multivariable analysis, age, preoperative tumor and CA-125 were significantly associated with disease-free survival (DFS); preoperative grade, tumor type, FIGO and CA-125 were significantly associated with disease-specific survival (DSS). Low-grade EC patients with elevated CA-125 revealed a DFS of 80.6% and DSS of 87.1%, compared to 92.1% and 97.2% in low-grade EC patients with normal CA-125. Preoperative elevated CA-125 was associated with poor prognostic features and independently associated with DFS and DSS. Particularly patients with low-grade EC and elevated CA-125 represent a group with poor outcome and should be considered as high-risk endometrial carcinoma.
Identifiants
pubmed: 31328454
pii: 30.e70
doi: 10.3802/jgo.2019.30.e70
pmc: PMC6658593
doi:
Substances chimiques
Biomarkers, Tumor
0
CA-125 Antigen
0
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
e70Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2019. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.
Déclaration de conflit d'intérêts
No potential conflict of interest relevant to this article was reported.
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