The utility of serum CA-125 in predicting extra-uterine disease in apparent early-stage endometrial cancer

Nicklin, James, Janda, Monika, Gebski, Val, Jobling, Thomas, Land, Russell, Manolitsas, Tom, McCartney, Anthony, Nascimento, Marcelo, Perrin, Lewis, Baker, Jannah F. and Obermair, Andreas (2011) The utility of serum CA-125 in predicting extra-uterine disease in apparent early-stage endometrial cancer. International Journal of Cancer, 131 4: 885-890. doi:10.1002/ijc.26433

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Author Nicklin, James
Janda, Monika
Gebski, Val
Jobling, Thomas
Land, Russell
Manolitsas, Tom
McCartney, Anthony
Nascimento, Marcelo
Perrin, Lewis
Baker, Jannah F.
Obermair, Andreas
Title The utility of serum CA-125 in predicting extra-uterine disease in apparent early-stage endometrial cancer
Journal name International Journal of Cancer   Check publisher's open access policy
ISSN 0020-7136
Publication date 2011-01-01
Year available 2012
Sub-type Article (original research)
DOI 10.1002/ijc.26433
Open Access Status Not yet assessed
Volume 131
Issue 4
Start page 885
End page 890
Total pages 6
Place of publication Hoboken, NJ, U.S.A.
Publisher John Wiley & Sons
Language eng
Subject 2730 Oncology
1306 Cancer Research
Abstract Surgical staging in early-stage uterine cancer is controversial. Preoperative serum CA-125 may be of clinical value in predicting the presence of extra-uterine disease in patients with apparent early-stage endometrial cancer. Between October 6, 2005, and June 17, 2010, 760 patients were enrolled in an international, multicentre, prospective randomized trial (LACE) comparing laparotomy with laparoscopy in the management of endometrial cancer apparently confined to the uterus. Of these, 657 patients with endometrial adenocarcinoma had a preoperative serum CA-125 value recorded. Multiple cross-validation analysis was undertaken to correlate preoperative serum CA-125 with stage of disease (Stage I vs. Stage II+) after surgery. Patients' median preoperative serum CA-125 was 14 U/ml. A cutoff point of 30 U/ml was associated with the smallest misclassification error, and using this cutoff, 98 patients (14.9%) had elevated CA-125 levels. Of those, 36 (36.7%) had evidence of extra-uterine disease. Of the 116 patients (17.7%) with evidence of extra-uterine disease, 31.0% had an elevated CA-125 level. On univariate and multivariable logistic regression analysis, only preoperative CA-125 level, but no other preoperative clinical characteristics were found to be associated with extra-uterine spread of disease. Utilizing a cutoff point of 30 U/ml achieved a sensitivity, specificity, positive predictive value and negative predictive value of 31.0, 88.5, 36.7 and 85.7%, respectively. Elevated CA-125 above 30 U/ml in patients with apparent early-stage disease is a risk factor for the presence of extra-uterine disease and may assist clinicians in the management of patients with clinical Stage I endometrial cancer.
Keyword Oncology
Q-Index Code C1
Q-Index Status Confirmed Code
Grant ID 456110
Institutional Status UQ
Additional Notes for the LACE Trial Investigators Article in Press. Article first published online: 19 NOV 2011

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
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Created: Fri, 16 Dec 2011, 20:24:32 EST by Matthew Lamb on behalf of School of Medicine