CA-125/CEA ratio as a prognostic factor in type II endometrial cancer: a single institute experience

Abstract

Objective: Type II (non-endometrioid) endometrial cancer is less common with an incidence of 10%-20%. It has an aggressive clinical course with heterogeneous clinic pathological features. The aim of this study is to evaluate prognostic factors and survival outcomes in type II endometrial cancer. Patients and Methods: Patients aged over 18 years with diagnosis of Stage IA-IVB type II endometrial cancer were included to the study. Between 2013 and 2019, a total of 76 patients were evaluated retrospectively. Results: Median overall survival (OS) was 25 months while median disease-free survival (DFS) was 22 months. Median DFS was 25 months (95% CI: 14.71-35.28) in patients with negative lymph nodes while it was 10 months (95% CI: 6.88-13.11) in patients with positive lymph nodes (p=0.017). Median OS was 28 months (95% CI: 23.05-32.95) in patients with a ratio of CA-125/CEA<25 while it was 16 months (95% CI: 5.19-26.80) in those with a ratio of CA-125/CEA≥25 (p=0.02). Patients with an Eastern Cooperative Oncology Group performance score (ECOG PS) <2 at the time of diagnosis had a significantly longer OS than ECOG PS≥2 [median 29 months (95% CI: 22.99-35.94) vs. 15 months (95% CI: 0.33-29.66); p=0.024]. In multivariate Cox regression analysis CA-125/CEA (HR:1.70, 95% CI: 1.01-2.83, p=0.042) was independent risk factor for OS. Conclusions: CA-125/CEA ratio may have prognostic significance in type 2 endometrial cancer, but it needs to be supported by randomized clinical trials.

Keywords

• type ii endometrial cancer
• ca-125/cea ratio
• prognosis