TY - JOUR
T1 - Utility of pre-operative serum CA-125 in the management of uterine papillary serous carcinoma
AU - Olawaiye, Alexander B.
AU - Rauh-Hain, Jose Alejandro
AU - Withiam-Leitch, Matthew
AU - Rueda, Bo
AU - Goodman, Annekathryn
AU - del Carmen, Marcela G.
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2008/9/1
Y1 - 2008/9/1
N2 - Objective: To evaluate the usefulness of pre-operative serum CA-125 in the management of women diagnosed with uterine papillary serous carcinoma (UPSC). We hypothesized that elevated pre-operative levels of serum CA-125 correlate with higher disease stage and poorer prognosis. Methods: Patients diagnosed with UPSC and managed in our institution were identified over a period of 10 years, 1995 to 2005. All required information were extracted from their records. The nonparametric test applied for comparison of data included Kruskal Wallis H-test and Man-Whitney U-test. The χ2 test and Spearman correlation test were used to examine the association of serum CA-125 with different parameters. Receiver operator characteristic curves (ROC) were used to quantify marker performance. Recurrence and survival were analyzed using Kaplan-Meier method. Multivariate analyses were performed with a Cox proportional regression method. Results: A total of 41 patients met the study criteria. Mean pre-operative serum CA-125 levels were significantly higher in patients with stage IV (1150 ± 1297 U/mL), compared with stage III (181 ± 232 U/mL; P < 0.001), stage II (22 ± 9; P < 0.001), and stage I (14 ± 1; P < 0.001). CA-125 correlated strongly with stage (r = 0.68, P < 0.001). On the ROC, a cut-off of 35 IU/mL provided the best sensitivity and specificity (78% vs. 100% respectively) for extra-uterine disease. Disease free survival (DFS) and overall survival (OS) were longer in patients with CA-125 < 35 U/mL compared with CA-125 ≥ 35 U/mL [median DFS not reached during study vs. 21.2 months (P = 0.009), and median OS not reached during study vs. 25 months, (P = 0.0001) respectively]. Multivariate regression model showed CA-125 as the only variable associated with survival (P = 0.05). Conclusion: Pre-operative serum CA-125 levels correlate with stage of disease in patients with UPSC. This may be important for management planning, prognostication and counseling in these women.
AB - Objective: To evaluate the usefulness of pre-operative serum CA-125 in the management of women diagnosed with uterine papillary serous carcinoma (UPSC). We hypothesized that elevated pre-operative levels of serum CA-125 correlate with higher disease stage and poorer prognosis. Methods: Patients diagnosed with UPSC and managed in our institution were identified over a period of 10 years, 1995 to 2005. All required information were extracted from their records. The nonparametric test applied for comparison of data included Kruskal Wallis H-test and Man-Whitney U-test. The χ2 test and Spearman correlation test were used to examine the association of serum CA-125 with different parameters. Receiver operator characteristic curves (ROC) were used to quantify marker performance. Recurrence and survival were analyzed using Kaplan-Meier method. Multivariate analyses were performed with a Cox proportional regression method. Results: A total of 41 patients met the study criteria. Mean pre-operative serum CA-125 levels were significantly higher in patients with stage IV (1150 ± 1297 U/mL), compared with stage III (181 ± 232 U/mL; P < 0.001), stage II (22 ± 9; P < 0.001), and stage I (14 ± 1; P < 0.001). CA-125 correlated strongly with stage (r = 0.68, P < 0.001). On the ROC, a cut-off of 35 IU/mL provided the best sensitivity and specificity (78% vs. 100% respectively) for extra-uterine disease. Disease free survival (DFS) and overall survival (OS) were longer in patients with CA-125 < 35 U/mL compared with CA-125 ≥ 35 U/mL [median DFS not reached during study vs. 21.2 months (P = 0.009), and median OS not reached during study vs. 25 months, (P = 0.0001) respectively]. Multivariate regression model showed CA-125 as the only variable associated with survival (P = 0.05). Conclusion: Pre-operative serum CA-125 levels correlate with stage of disease in patients with UPSC. This may be important for management planning, prognostication and counseling in these women.
KW - CA-125
KW - Endometrial cancer
KW - Papillary serous
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U2 - 10.1016/j.ygyno.2008.05.027
DO - 10.1016/j.ygyno.2008.05.027
M3 - Article
C2 - 18644620
AN - SCOPUS:50349084762
SN - 0090-8258
VL - 110
SP - 293
EP - 298
JO - Gynecologic Oncology
JF - Gynecologic Oncology
IS - 3
ER -