Cancers (May 2023)
Preoperative CA125 Significantly Improves Risk Stratification in High-Grade Endometrial Cancer
- Marike S. Lombaers,
- Karlijn M. C. Cornel,
- Nicole C. M. Visser,
- Johan Bulten,
- Heidi V. N. Küsters-Vandevelde,
- Frédéric Amant,
- Dorry Boll,
- Peter Bronsert,
- Eva Colas,
- Peggy M. A. J. Geomini,
- Antonio Gil-Moreno,
- Dennis van Hamont,
- Jutta Huvila,
- Camilla Krakstad,
- Arjan A. Kraayenbrink,
- Martin Koskas,
- Gemma Mancebo,
- Xavier Matías-Guiu,
- Huy Ngo,
- Brenda M. Pijlman,
- Maria Caroline Vos,
- Vit Weinberger,
- Marc P. L. M. Snijders,
- Sebastiaan W. van Koeverden,
- ENITEC-Consortium,
- Ingfrid S. Haldorsen,
- Casper Reijnen,
- Johanna M. A. Pijnenborg
Affiliations
- Marike S. Lombaers
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Karlijn M. C. Cornel
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Nicole C. M. Visser
- Department of Pathology, Eurofins PAMM, 5623 EJ Eindhoven, The Netherlands
- Johan Bulten
- Department of Pathology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Heidi V. N. Küsters-Vandevelde
- Department of Pathology, Canisius-Wilhelmina Hospital, 6532 SZ Nijmegen, The Netherlands
- Frédéric Amant
- Department of Oncology, KU Leuven, 3000 Leuven, Belgium
- Dorry Boll
- Department of Gynecology, Catharina Hospital, 5623 EJ Eindhoven, The Netherlands
- Peter Bronsert
- Institute of Pathology, University Medical Center, 79104 Freiburg, Germany
- Eva Colas
- Biomedical Research Group in Gynecology, Vall Hebron Institute of Research, Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red Cáncer, 08193 Barcelona, Spain
- Peggy M. A. J. Geomini
- Department of Obstetrics and Gynecology, Maxima Medical Centre, 5631 BM Veldhoven, The Netherlands
- Antonio Gil-Moreno
- Biomedical Research Group in Gynecology, Vall Hebron Institute of Research, Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red Cáncer, 08193 Barcelona, Spain
- Dennis van Hamont
- Department of Obstetrics and Gynecology, Amphia Hospital, Breda, 4818 CK Breda, The Netherlands
- Jutta Huvila
- Department of Pathology, University of Turku, 20500 Turku, Finland
- Camilla Krakstad
- Department of Obstetrics and Gynecology, Haukeland University Hospital, 5021 Bergen, Norway
- Arjan A. Kraayenbrink
- Department of Obstetrics and Gynaecology, Rijnstate Hospital, 6815 AD Arnhem, The Netherlands
- Martin Koskas
- Department of Obstetrics and Gynecology, Bichat-Claude Bernard Hospital, 75018 Paris, France
- Gemma Mancebo
- Department of Obstetrics and Gynecology, Hospital del Mar, Parc de Salut Mar, 08003 Barcelona, Spain
- Xavier Matías-Guiu
- Department of Pathology and Molecular Genetics and Research Laboratory, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLleida, Centro de Investigación Biomédica en Red Cáncer, 25003 Lleida, Spain
- Huy Ngo
- Department of Obstetrics and Gynecology, Elkerliek Hospital, 5751 CB Helmond, The Netherlands
- Brenda M. Pijlman
- Department of Obstetrics and Gynecology, Jeroen Bosch Hospital, 5223 GZ ‘s-Hertogenbosch, The Netherlands
- Maria Caroline Vos
- Department of Obstetrics and Gynecology, Elisabeth-TweeSteden Hospital, 5000 LC Tilburg, The Netherlands
- Vit Weinberger
- Department of Gynecology and Obstetrics, University Hospital Brno, Faculty of Medicine, Masaryk University, 601 77 Brno, Czech Republic
- Marc P. L. M. Snijders
- Department of Obstetrics and Gynecology, Canisius-Wilhelmina Hospital, 6532 SZ Nijmegen, The Netherlands
- Sebastiaan W. van Koeverden
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- ENITEC-Consortium
- Ingfrid S. Haldorsen
- Department of Obstetrics and Gynecology, Haukeland University Hospital, 5021 Bergen, Norway
- Casper Reijnen
- Department of Radiation Oncology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Johanna M. A. Pijnenborg
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- DOI
- https://doi.org/10.3390/cancers15092605
- Journal volume & issue
-
Vol. 15,
no. 9
p. 2605
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 p p 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.
Keywords
