Abstract:

Abstract Aim: To investigate the CA-125 levels in uterine serous carcinoma (UPSC) patients to predict the extent of disease. Materials and Method: Medical records of patients operated for UPSC/mix serous carcinoma, endometrioid carcinoma; their preoperative CA-125 levels, as well as parameters including age, tumor size, lymph node involvement, lymphovascular space invasion (LVSI), depth of myometrial invasion (MI) and stage were documented. Results: Twenty-six UPSC/mix serous carcinoma cases and forty-five endometrioid carcinoma cases were included. When we analyzed the serous cancer group in terms of CA-125; there was no association between CA-125 and age (≤60 vs >60), tumor size (≤40 vs >40mm), MI, lymph node metastasis or LVSI. The mean CA-125 levels were significantly higher among patients with stage III/IV (median=54 U/ml), compared to stage I/II (median=11 U/mL). The mean CA-125 value for tumors spread beyond the uterus were 281.2 U/ml, and 14.3 U/ml for the tumors confined within the uterus (p=0.002). The optimum threshold value to predict extrauterine spread was 28.5 U/mL. CA-125 level was related to extrauterine involvement and advanced stage. Conclusion: CA-125 level is a useful test for extrauterine involvement and advanced stage. We suggest a less aggressive treatment modality with CA-125 <28.5U/mL may be considered for patients with a pre-operative CA 125 level of <28.5 and who cannot bear extensive surgery burden. Patients with a pre-operative CA 125 level of >28.5 and who need to receive comprehensive surgical staging, in settings where this is not feasible, should be referred to a gynecological oncologist in an experienced center.

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