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#483 Pretreatment carcinoembryonic antigen can assist cancer antigen 125 in predicting lymph node metastasis in endometrial carcinoma
  1. Szu-Yu Huang1,
  2. Hung-Chun Fu1,
  3. Chen-Hsuan Wu1,
  4. Shao-Chi Wang1,
  5. Yu-Che Ou1,2,
  6. Ching-Chou Tsai1,
  7. Ying-Yi Chen1,
  8. Szu-Wei Huang1,
  9. Ying-Wen Wang1 and
  10. Hao Lin1
  1. 1Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
  2. 2Department of Obstetrics and Gynecology, Chia-Yi Chang Gung Memorial Hospital, ChiaYi, Taiwan


Introduction/Background We aimed to investigate whether the cost-effective, pretreatment tumor markers carcinoembryonic antigen (CEA) and carbohydrate antigen-125 (CA-125) can be used to predict lymph node metastasis (LNM) in endometrioid-type endometrial cancer (EC) and to develop a predictive model.

Methodology This was a single-center retrospective study of patients with endometrioid-type EC who underwent complete staging surgery between January 2015 and June 2022.

Results The optimal cut-off values of CEA and CA-125 were 1.4 ng/mL (area under the ROC curve (AUC) 0.62) and 40 U/mL (AUC 0.75), respectively. Multivariate analysis showed that CEA (odds ratio (OR): 1.94; 95% confidence interval (CI): 1.01–3.74) and CA-125 (OR: 8.75; 95% CI: 4.42–17.31) were independent predictors of LNM. Our nomogram showed adequate discrimination with a concordance index of 0.78. Calibration curves for the probability of LNM showed optimal agreement between the predicted and actual probabilities. The risk of LNM for markers below the cut-offs was 3.6%. The negative predictive value and negative likelihood ratio were 96.6% and 0.26, respectively, with moderate ability to rule out the possibility of LNM.

Conclusion We report a cost-effective method of using pretreatment CEA and CA-125 levels to identify patients with endometrioid-type EC who are at a low risk for LNM, which may guide decision-making regarding aborting lymphadenectomy.

Disclosures There are no conflicts of interest to declare.

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