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

Authors

  • 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

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Published

2019-09-06

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Section

Research Articles