In patients with uterine cancer, high serum levels of CA 125 are predictive of positive lymph node status and extrauterine spread of disease, according to a report published in the May issue of the American Journal of Obstetrics and Gynecology.
The findings indicate that CA 125 is an independent predictor of advanced disease and suggest that testing “should be included in the preoperative workup for all patients with uterine cancer,” lead author Dr. Helen Jhang and colleagues, from Westchester Medical Center in Valhalla, New York, note.The results are based on an analysis of data from 65 women with uterine cancer who had CA 125 levels measured prior to undergoing resection.The researchers found that the CA 125 level was directly related to disease stage and the risk of nodal involvement (p < 0.0001 for both). In addition, high levels were associated with deepest myometrial invasion, lymph vascular space involvement, and high tumor grade.CA 125 was better at predicting advanced-stage disease than depth of invasion, lymph vascular space involvement, and tumor grade. CA 125 correctly predicted advanced disease 94% of the time, whereas the predictive ability of the other parameters did not exceed 80%.The researchers calculate that, with a cutoff value of 37 IU/mL, CA 125 was 95% sensitive and 90% specific in predicting advanced-stage disease.Although these preliminary findings are encouraging, "a larger multicenter study is needed to determine whether CA 125 is indeed better than other well-established prognostic factors in the prediction of advanced-stage uterine cancer," Dr. Jhang's team concludes.(Source: Am J Obstet Gynecol 2003;188:1195-1197: Reuters Health: May 29, 2003: Oncolink)