Value of pre-operative serum CA125 level for prediction of prognosis in patients with endometrial cancer

Background: High pre-operative CA125 levels in women with endometrial cancer may be related to lymph node metastases and poor prognosis. Aim: To evaluate whether pre-operative cancer antigen 125 (CA125) levels are associated with lymph node metastases and prognosis in endometrial cancer. Methods: One hundred and twenty women with endometrial cancer were retrospectively reviewed for pre-operative CA125 levels. The results were then correlated with the clinicopathological outcome. Results: An elevated CA125 (>40 U/mL) was significantly correlated with higher stage, higher grade, increased depth of myometrial invasion, lymph node metastases and the presence of lympho-vascular space involvement in endometrial cancer. Five-year overall survival (OS) and recurrence-free survival (RFS) rates were significantly higher in women with endometrial cancer with CA125 <= 40 U/mL than those with CA125 > 40 U/mL (P < 0.001). When women were further stratified according to CA125 levels and lymph node status, OS and RFS were highest for those with CA125 <= 40 U/mL and without lymph node metastases, and lowest for those with lymph node metastases and CA125 > 40 U/mL (P < 0.001). Conclusion: The testing of pre-operative CA125 levels may a useful prognostic tool in endometrial cancer management.