Obstet Gynecol Sci.  2013 Sep;56(5):281-288.

Predictive value of preoperative serum CA-125 levels in patients with uterine cancer: The Asian experience 2000 to 2012

• Patsner B
• Yim GW

Abstract

OBJECTIVE
Much of the early investigative work on the usefulness of preoperative serum CA-125 levels in identifying patients with early-stage endometrial carcinoma who have occult metastases were carried out in Europe and the United States. This article reviews CA-125 as a possible index for determining the need for full surgical staging, from the results of large medical centers in Asia, particularly Taiwan and Korea.
METHODS
A Medline search was performed using CA-125 and endometrial cancer as index words from 1981 to 2012. Those publications felt to be the most important especially from institutions from Asia since 2000 were identified in this review.
RESULTS
Most articles that analyzed the utility of serum CA-125 levels as predictive marker for disease extent or prognosis in uterine cancer used univariate and multivariable logistic regression analysis, and performed receiver operative curves to find the best cut-off values. The main factor of interest was whether clinicians can stratify patients that need lymphadenectomy in early stage disease. Suggested optimal cut-off value ranged from 20 to 210 U/mL. Not only preoperative CA-125 level, but myometrial invasion status by magnetic resonance imaging was the most significant combined parameter for predicting disease extent.
CONCLUSION
Elevated CA-125 in patients with apparent early-stage disease is clearly a risk factor for the presence of extra-uterine disease although the optimal cut-off levels vary. The evolution of clinical investigations over the past decade, particularly in Asia, suggests employment of the test in a more focused manner to identify high risk patients preoperatively.

Keyword

CA-125 antigen; Neoplasm staging; Uterine neoplasm

MeSH Terms

Asia
Asian Continental Ancestry Group
CA-125 Antigen
Employment
Endometrial Neoplasms
Europe
Female
Humans
Logistic Models
Lymph Node Excision
Magnetic Resonance Imaging
Neoplasm Metastasis
Neoplasm Staging
Prognosis
Risk Factors
Taiwan
United States
Uterine Neoplasms
CA-125 Antigen

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