The accuracy of preoperative serum CA-125 levels to predict lymph node metastasis in a population of South African women with endometrial carcinoma

  • Kartika Hapsari University of Pretoria
  • Jennifer D Makin University of Pretoria
  • Greta Dreyer University of Pretoria
Keywords: CA-125, endometrium carcinoma, lymph nodes metastases, surgical management

Abstract

Background: The purpose of the study was to evaluate the predictive value of serum CA-125 levels in the preoperative assessment of endometrial carcinoma in a setting where late presentation is common.

Method: This retrospective study evaluated women with pathologically proven endometrial carcinoma scheduled for surgery between January 2012 and January 2017, who had preoperative serum CA-125 test results. The association of CA-125 with a variety of histological factors was evaluated using Spearman’s correlation and receiver operator characteristic (ROC) curves to evaluate sensitivity and specificity.

Results: Fifty-eight patients were included in the study, 34 (58.6%) of whom were FIGO stage II–IV. Elevated CA 125 levels were significantly correlated with late FIGO stage (p < 0.001), myometrial invasion (p < 0.001) and lymph node metastases (p < 0.001). The most appropriate cut-off point of CA-125, where an increase in sensitivity was not associated with a fall-off in specificity, was 20 IU/ml, reaching a sensitivity of 90% and a specificity of 67% for detection of lymph node metastases.

Conclusion: Among this group of women with endometrial cancer, the preoperative serum CA-125 level was associated with lymph node metastases and we found a CA-125 of 20 IU/ml or more to be predictive. These findings suggest that, among similar populations, CA-125 could be done preoperatively and could be used to determine the need for node dissection. Since our findings are from a small retrospective cohort, this should be validated in a prospective study on early stage disease.

The full article is available at https://doi.org/10.1080/20742835.2019.1603833

Author Biographies

Kartika Hapsari, University of Pretoria

Department of Obstetrics and Gynaecology, Faculty of Health Sciences, School of Medicine, University of Pretoria,
Pretoria, South Africa

Jennifer D Makin, University of Pretoria

Department of Obstetrics and Gynaecology, Faculty of Health Sciences, School of Medicine, University of Pretoria,
Pretoria, South Africa

Greta Dreyer, University of Pretoria

Department of Obstetrics and Gynaecology, Faculty of Health Sciences, School of Medicine, University of Pretoria,
Pretoria, South Africa

Published
2019-09-06
Section
Research Articles