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Performance of Serum CA125 as a Prognostic Biomarker in Patients With Uterine Papillary Serous Carcinoma
  1. Divya Gupta, MD*,
  2. Marc J. Gunter, PhD,
  3. Kathleen Yang, MD,
  4. Stephen Lee, MD§,
  5. Lisa Zuckerwise, MD§,
  6. Lee-may Chen, MD,
  7. Gary L. Goldberg, MD§ and
  8. Gloria S. Huang, MD§
  1. *Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Weill Cornell Medical College and New York Presbyterian Hospital, New York, NY;
  2. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY;
  3. Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Health, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA;
  4. §Division of Gynecologic Oncology, Departments of Obstetrics & Gynecology and Women's Health, and
  5. Molecular Pharmacology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY.
  1. Address correspondence and reprint requests to Divya Gupta, MD, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Weill Cornell Medical College, 525 E 68th St, Suite J-130, New York, NY 10065. E-mail: dig2010{at}med.cornell.edu or Gloria Huang, MD, Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, 1695 Eastchester Road, Suite 601, Bronx, NY 10461. E-mail: gloria.huang{at}einstein.yu.edu.

Abstract

Hypothesis Serum CA125 is a potential biomarker for metastatic disease and recurrence in patients with uterine papillary serous carcinoma (UPSC).

Methods All patients with UPSC who had preoperative CA125 measurement and surgical staging between 1998 and 2008 at the participating institutions were included in this analysis (N = 52). Data were extracted from patients' records. Fisher exact and χ2 tests were used to assess the association of CA125 levels with clinical and pathological variables. The correlation between CA125 levels (high/low) and lymph node metastases (positive/negative) was evaluated using Spearman correlation coefficients. The association of CA125 elevation with recurrence-free survival was assessed using Cox proportional hazards regression modeling.

Results Preoperative CA125 elevation (>30 U/mL) was observed in 9 (17%) patients and was associated with advanced International Federation of Gynecologists and Obstetricians (FIGO) stage III/IV disease (P = 0.002), lymph node involvement (P = 0.007), and presence of omental metastases (P = 0.001). Disease recurrence and survival data were available for 51 of the 52 patients. During a mean follow-up time of 36 months, 15 (29%) patients experienced disease recurrence and 10 (19%) patients died. There was a moderate positive correlation between CA125 levels and lymph node metastases (r 2 = 0.39). On multivariate survival analysis, an elevated CA125 level compared to nonelevated CA-125 was not associated with disease recurrence (hazard ratio, 1.61; 95% confidence interval, 0.55-4.77).

Conclusions Preoperative CA125 levels were significantly associated with metastatic disease in patients with UPSC. However, in this study of surgically staged UPSC patients, preoperative CA125 elevation was not an independent predictor of disease recurrence.

  • Uterine papillary serous carcinoma
  • UPSC
  • CA125
  • Biomarker

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Footnotes

  • Institutional funding was from the Albert Einstein College of Medicine, the Montefiore Medical Center, and the University of California San Francisco. Dr. Huang is an ACOG scholar of the Reproductive Scientist Development Program (RSDP).

  • The authors have no conflicts of interest to disclose.

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