Preoperative CA-125 predicts extra-uterine disease and survival in uterine papillary serous carcinoma patients

2012 ◽  
Vol 27 (3) ◽  
pp. 263-271 ◽  
Author(s):  
Thijs Roelofsen ◽  
Marjanka Mingels ◽  
Jan C.M. Hendriks ◽  
Rahul A. Samlal ◽  
Marc P. Snijders ◽  
...  
Keyword(s):  
Elevated Serum ◽  
Progression Free Survival ◽  
Figo Stage ◽  
Serous Carcinoma ◽  
Ca 125 ◽  
Uterine Disease ◽  
Uterine Papillary Serous Carcinoma ◽  
Kaplan Meier ◽  
Preoperative Serum ◽  
Papillary Serous Carcinoma

Objective We determined the clinical utility of preoperative serum CA-125 as predictor of extra-uterine disease and as prognosticator for survival in patients with uterine papillary serous carcinoma (UPSC). Methods Patients diagnosed with UPSC, identified between 1992 and 2009, and with preoperative CA-125 measurement were included. A receiver operator characteristic (ROC) curve was used to quantify marker performance. Overall and progression free survival were analyzed using the Kaplan-Meier method. Regression analyses were used to investigate the association of preoperative CA-125 levels and other clinicopathological variables with the presence of extra-uterine disease and the effects on survival. Results Sixty-six patients met the study criteria. Using ROC, the CA-125 concentration of 45 U/mL as cutoff level provided the best sensitivity (75%) and specificity (74%) for extra-uterine disease, with a positive predictive value of 86%. Survival was significantly longer in patients with preoperative CA-125 =45 U/mL (p<0.001). Only preoperative CA-125 >45 U/mL remained significantly associated with extra-uterine disease (OR=6.30, 95% CI 1.93–20.62). Furthermore, advanced FIGO stage (HR=4.53, 95% CI 1.50–13.62) and preoperative CA-125 >45 U/mL (HR=3.12, 95% CI 1.13–8.73) were associated with decreased survival. Conclusion Preoperative elevated serum CA-125 is an independent predictor for the presence of extra-uterine disease and an independent risk factor for survival in UPSC patients.

Serum CA-125 as a marker of disease activity in uterine papillary serous carcinoma

1999 ◽  
Vol 125 (12) ◽  
pp. 697-698 ◽  
Author(s):  
Drew Abramovich ◽  
Maurie Markman ◽  
Alexander Kennedy ◽  
Kenneth Webster ◽  
Jerome Belinson
Keyword(s):  
Disease Activity ◽  
Serous Carcinoma ◽  
Ca 125 ◽  
Uterine Papillary Serous Carcinoma ◽  
Papillary Serous Carcinoma

Utility of pre-operative serum CA-125 in the management of uterine papillary serous carcinoma

2008 ◽  
Vol 110 (3) ◽  
pp. 293-298 ◽  
Author(s):  
Alexander B. Olawaiye ◽  
Jose Alejandro Rauh-Hain ◽  
Matthew Withiam-Leitch ◽  
Bo Rueda ◽  
Annekathryn Goodman ◽  
...  
Keyword(s):  
Serous Carcinoma ◽  
Ca 125 ◽  
Uterine Papillary Serous Carcinoma ◽  
Papillary Serous Carcinoma

Cancer Antigen 125 Levels are Significantly Associated With Prognostic Parameters in Uterine Papillary Serous Carcinoma

2018 ◽  
Vol 28 (7) ◽  
pp. 1311-1317 ◽  
Author(s):  
Meirav Schmidt ◽  
Yakir Segev ◽  
Rotem Sadeh ◽  
Erica Suzan ◽  
Ido Feferkorn ◽  
...  
Keyword(s):  
Lymph Node ◽  
Serous Carcinoma ◽  
Ca 125 ◽  
Prognostic Parameters ◽  
Cancer Antigen 125 ◽  
Optimal Cutoff ◽  
Positive Cytology ◽  
Cancer Antigen ◽  
Uterine Papillary Serous Carcinoma ◽  
Papillary Serous Carcinoma

ObjectivesUterine papillary serous carcinoma (UPSC) is a highly aggressive subtype of endometrial carcinoma. Histopathologically, it resembles the pattern of serous papillary carcinoma of the ovary. Cancer antigen 125 (CA-125) is the most widely used biomarker in epithelial ovarian carcinoma. Its use in UPSC evaluation has yet to be determined. The purpose of this study was to investigate the significance of preoperative serum CA-125 as a prognostic factor in patients with UPSC.MethodsThe study cohort included all women with UPSC operated in our institution between January 2002 and June 2016. All patients underwent complete surgical staging. Preoperative CA-125 was reviewed and correlated with clinical and pathological parameters.ResultsSixty-one women met the study criteria. Median preoperative CA-125 was found to be significantly associated with disease stage. Patients with disease stages I to IV had median preoperative CA-125 levels of 12.15, 19.6, 22.6, and 177.5 U/mL (P < 0.0001) respectively. Levels of CA-125 were significantly associated with positive cytology (P < 0.0001), omental disease (P < 0.0001), pelvic or para-aortic lymph node metastasis (P < 0.0001), and adnexal involvement (P < 0.0001). The optimal cutoff that provided the best sensitivity and specificity for omental and parametrial involvement as well as positive cytology was 57.5 U/mL. For adnexal and lymph node involvement, the optimal cutoff value was 41.8 U/mL.ConclusionsIn patients with UPSC, preoperative CA-125 level correlates with known prognostic parameters of endometrial carcinoma and is associated with extrauterine involvement. These data should stimulate the need for further evaluation of the role of CA-125 in predicting recurrence and survival in UPSC.

Identification of a Preoperative Predictive Factor for Lymph Node Metastasis in Uterine Papillary Serous Carcinoma: Long-term Results From a Single Institution

2015 ◽  
Vol 25 (1) ◽  
pp. 69-74 ◽  
Author(s):  
Min-Hyun Baek ◽  
Shin-Wha Lee ◽  
Jeong-Yeol Park ◽  
Daeyeon Kim ◽  
Jong-Hyeok Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Predictive Factor ◽  
Tumor Size ◽  
Long Term Results ◽  
Serous Carcinoma ◽  
Ca 125 ◽  
Preoperative Imaging ◽  
Uterine Papillary Serous Carcinoma ◽  
Papillary Serous Carcinoma

ObjectiveThe purpose of this study was to identify preoperative clinicopathological predictive factors for lymph node (LN) metastasis in women diagnosed with uterine papillary serous carcinoma (UPSC).MethodsWomen diagnosed with UPSC in our institution from 1997 to 2012 were identified. All patients underwent hysterectomy and bilateral salpingo-oophorectomy plus pelvic and/or para-aortic lymphadenectomy. The predictive values of the risk factors for LN metastasis were analyzed using χ2 and multivariate logistic regression analyses.ResultsA total of 94 patients met our study criteria. A CA-125 cutoff of 47.5 IU/mL on the receiver operating characteristic curve provided the best sensitivity and specificity (56.5% vs 90.1%, respectively) for LN metastasis prediction. The sensitivities and specificities of old age (≥60 years), body mass index of 25 kg/m2 or greater, deep myometrial invasion, tumor size greater than 2 cm, tumor size greater than 4 cm, preoperative CA-125 greater than 47.5 IU/mL, LN metastasis on imaging, and extrauterine spread on imaging for the presence of a positive LN were 39.1%, 34.8%, 30.4%, 34.8%, 21.7%, 56.5%, 43.5%, and 52.2%, and 52.1%, 45.1%, 78.9%, 57.7%, 83.1%, 90.1%, 93.0%, and 90.1%, respectively. Preoperative CA-125 (P < 0.001), LN metastasis on preoperative imaging (P < 0.001), and extrauterine spread on preoperative imaging (P = 0.009) were risk factors for LN metastasis on univariate analysis. Multivariate analysis revealed that preoperative CA-125 (P = 0.001) was the only independent risk factor for LN metastasis.ConclusionsPreoperative CA-125 is a preoperative predictive factor for LN metastasis in UPSC.

A review of the pathology and management of uterine papillary serous carcinoma and correlation with outcome

2006 ◽  
Vol 16 (3) ◽  
pp. 972-978 ◽  
Author(s):  
D. Faratian ◽  
A. Stillie ◽  
R. M.C. Busby-Earle ◽  
V. J. Cowie ◽  
H. Monaghan
Keyword(s):  
Univariate Analysis ◽  
Prognostic Significance ◽  
Progression Free Survival ◽  
Poor Response ◽  
Serous Carcinoma ◽  
Uterine Papillary Serous Carcinoma ◽  
Local Practices ◽  
Response To Chemotherapy ◽  
Diagnostic Biopsy ◽  
Papillary Serous Carcinoma

Uterine papillary serous carcinoma (UPSC) accounts for 10% of endometrial carcinomas but a higher proportion of deaths due to its aggressive nature and poor response to chemotherapy and radiotherapy. In order to add to the knowledge of UPSC in the literature and to review our local practices, we examined the pathology, medical records, and management of all cases of UPSC (67 patients) treated in South East Scotland over a 10-year period and also evaluated the prognostic significance of the percentage of UPSC in endometrial pipelle and hysterectomy specimens. Although only 63% of initial diagnostic biopsies were reported to contain UPSC, rereview of the cases revealed UPSC in 98.5% of the preoperative biopsies. The percentage of UPSC in the tumors did not affect the outcome. Stage, positive omentum, and treatment with external-beam +/− intracavitary radiotherapy were significantly correlated with overall survival and progression-free survival by univariate analysis, but only stage (P < 0.01) was correlated with outcome on multivariate analysis. Chemotherapy did not affect outcome. UPSC may be difficult to diagnose in preoperative biopsies, particularly when present as part of a mixed tumor. Even a small percentage of UPSC in a diagnostic biopsy or hysterectomy specimen is correlated with a poor prognosis. This study emphasizes the need of a cooperative, prospective study on this distinct uterine carcinoma.

FIGO stage III and IV uterine papillary serous carcinoma: Impact of residual disease on survival

2002 ◽  
Vol 12 (5) ◽  
pp. 454-458 ◽  
Author(s):  
S. Memarzadeh ◽  
C. H. Holschneider ◽  
R. E. Bristow ◽  
N. L. Jones ◽  
Y. S. Fu ◽  
...  
Keyword(s):  
Residual Disease ◽  
Figo Stage ◽  
Stage Iii ◽  
Serous Carcinoma ◽  
Free Survival ◽  
Uterine Papillary Serous Carcinoma ◽  
Microscopic Residual Disease ◽  
Papillary Serous Carcinoma ◽  
The Impact ◽  
Tumor Registries

The objective of this study was to assess the impact of surgical cytoreduction on the survival of patients with uterine papillary serous carcinoma (UPSC). Patients added to the institutional tumor registries between January 1980 and September 2001 with the diagnosis of UPSC were reviewed. The records of 43 patients who underwent surgical cytoreduction for FIGO stage III and IV disease were reviewed. The median survival of UPSC patients with microscopic residual disease was significantly improved compared to those with macroscopic residual disease following primary surgical cytoreduction. We conclude that primary surgical cytoreduction resulting in microscopic residual disease is associated with an improvement in recurrence-free survival and overall survival in women with UPSC.

Uterine papillary serous carcinoma: evaluation of multimodality treatment with abdominopelvic radiotherapy and chemotherapy

2006 ◽  
Vol 16 (Suppl 1) ◽  
pp. 278-285 ◽  
Author(s):  
H. Steed ◽  
L. Manchul ◽  
B. Rosen ◽  
A. Fyles ◽  
G. Lockwood ◽  
...  
Keyword(s):  
Progression Free Survival ◽  
Multimodality Treatment ◽  
Postoperative Treatment ◽  
Serous Carcinoma ◽  
Postoperative Adjuvant Therapy ◽  
Free Survival ◽  
Treatment Groups ◽  
Uterine Papillary Serous Carcinoma ◽  
Papillary Serous Carcinoma ◽  
Relapse Patterns

The aim of this study was to compare overall survival (OS), progression-free survival (PFS), and relapse patterns between different modalities of treatment for uterine papillary serous carcinoma (UPSC). A retrospective review of 124 patients with pathologically confirmed UPSC was performed, of whom, 97 patients were eligible for study. Postoperative treatment groups included adjuvant radiotherapy consisting of whole abdomen and a pelvic boost (abdominopelvic radiotherapy [APRT]) (55 patients), paclitaxel and carboplatin chemotherapy (CT) for six cycles followed by APRT (18 patients), CT only (5 patients), and 19 patients were observed without postoperative adjuvant therapy. Three-year OS was 81% and 63% for the CT followed by APRT and APRT alone, respectively (P= 0.11). After controlling for stage, the group treated with APRT alone had significantly decreased OS and PFS compared to the CT/APRT group (HR 3.6; 1.3–9.8; P= 0.01) and (HR 2.9; 95% CI 1.1–7.3; P= 0.03), respectively. Within the limitations of a retrospective study, the results of this study indicate that multimodality postoperative treatment with paclitaxel and a platinum-based CT followed by APRT may increase the survival of patients with UPSC. However, further prospective studies using these combined modalities are needed to confirm these findings.

FIGO stage III and IV uterine papillary serous carcinoma: Impact of residual disease on survival

2002 ◽  
Vol 12 (5) ◽  
pp. 454-458 ◽  
Author(s):  
S. Memarzadeh ◽  
C. H. Holschneider ◽  
R. E. Bristow ◽  
N. L. Jones ◽  
Y. S. Fu ◽  
...  
Keyword(s):  
Residual Disease ◽  
Figo Stage ◽  
Stage Iii ◽  
Serous Carcinoma ◽  
Uterine Papillary Serous Carcinoma ◽  
Papillary Serous Carcinoma

Performance of Serum CA125 as a Prognostic Biomarker in Patients With Uterine Papillary Serous Carcinoma

2011 ◽  
Vol 21 (3) ◽  
pp. 529-534 ◽  
Author(s):  
Divya Gupta ◽  
Marc J. Gunter ◽  
Kathleen Yang ◽  
Stephen Lee ◽  
Lisa Zuckerwise ◽  
...  
Keyword(s):  
Lymph Node ◽  
Metastatic Disease ◽  
Lymph Node Metastases ◽  
Disease Recurrence ◽  
Serous Carcinoma ◽  
Ca 125 ◽  
Uterine Papillary Serous Carcinoma ◽  
Serum Ca125 ◽  
Node Metastases ◽  
Papillary Serous Carcinoma

HypothesisSerum CA125 is a potential biomarker for metastatic disease and recurrence in patients with uterine papillary serous carcinoma (UPSC).MethodsAll 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 χ2tests 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.ResultsPreoperative 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 (r2= 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).ConclusionsPreoperative 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.

Sign in / Sign up

Export Citation Format

Share Document