J Gynecol Oncol.  2009 Sep;20(3):181-186. 10.3802/jgo.2009.20.3.181.

Premenopausal early-stage endometrial carcinoma patients with low CA-125 levels and low tumor grade may undergo ovary-saving surgery

• Yoo SC
• Yoon JH
• Kim WY
• Chang SJ
• Joo HJ
• Chang KH
• Ryu HS

• KMID: 2173452
• DOI: http://doi.org/10.3802/jgo.2009.20.3.181

Abstract

OBJECTIVE
The purpose of this study was to determine the possible predicting factors of coexisting adnexal malignancies, and to evaluate the safety of ovary-saving surgery for early-stage endometrial carcinoma in premenopausal patients. METHODS: A retrospective review of 107 patients with endometrial carcinoma who underwent surgical treatment at our institution was conducted. All patients were younger than 50 years of age and premenopausal status. Statistical analysis was performed. RESULTS: Of the 107 patients, 78 patients had stage I to II disease and both preoperative CA-125 levels were measured and tumor grades evaluated. On multivariate analysis, preoperative CA-125 levels (p=0.018) and preoperative tumor grade (p=0.029) were independent predicting factors of adnexal diseases. The risk of coexisting ovarian malignancy was 1.8% in patients with preoperative CA-125 levels less than or equal to 34.5 U/ml and preoperative tumor grade 1 or 2. The risk increases to 20% for low CA-125 and grade 3, 13.3% for high CA-125 and grade 1 or 2, and 100% for high CA-125 and grade 3. Between patients who underwent unilateral salpingo-oophorectomy and those who underwent bilateral salpingo-oophorectomy, there was no statistically significant difference in terms of BMI, preoperative CA-125 levels, FIGO stage, histology, tumor grade, lymphadenectomy, and adjuvant treatment. CONCLUSION: Ovary-saving surgery for premenopausal, early-stage endometrial cancer patients may be considered as a treatment option in those with low preoperative CA-125 and low tumor grade.

Keyword

Premenopausal women; Endometrial carcinoma; Ovary-saving surgery

MeSH Terms

Adnexal Diseases
Endometrial Neoplasms
Female
Humans
Lymph Node Excision
Multivariate Analysis
Retrospective Studies

Figure

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  Fig. 1 ROC curve of preoperative CA-125 level for coexisting adnexal disease (AUC, 0.935; SE, 0.033; p<0.001; 95% CI, 0.871-0.999).

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  Fig. 2 Coexisting adnexal disease for the cohorts of 78 premenopausal women less than 50 years of age with endometrial carcinoma and who have available data of preoperative CA-125 and tumor grade.

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