Abstract

INTRODUCTION

This study aimed to determine the relationship between preoperative cancer antigen(CA)-125 levels and clinicopathologic prognostic factors as well as appropriate cut-off levels for pure uterine papillary serous carcinoma.

METHODS

Study data were collected from the documents and electronic medical records of patients who were diagnosed with pure uterine papillary serous carcinoma between 2005 and 2020 in our institution. The association between clinicopathological variables and CA-125 were analyzed. The accuracy of the preoperative serum CA-125 value in predicting metastasis sites was evaluated by the receiving operating characteristic curve analysis and the most appropriate cut-off values available were selected.

RESULTS

Seventy-eight patients met the study criteria. Median value of preoperative serum CA-125 level was higher in patients with omental (P <0.001), ovarian (P <0.001), cervical involvement (P = 0.017) and deep myometrial invasion (≥50%) (P = 0.001). According to the receiving operating characteristic curve, the optimal cut-off value of preoperative CA-125 level for predicting omental involvement was 35.5 U/mL (sensitivity: 93.8%, specificity: 79.3%), cervical involvement was 15.0 U/mL (sensivity: 86.8%, specificity: 44.7%) and ovarian involvement was 32.5 U/mL (sensivity: 77.3%, specificity: 72.2%).

DISCUSSION AND CONCLUSION

An elevated level of preoperative serum CA-125 is a marker for omental, ovarian, cervical involvement and deep myometrial invasion. The value for cervical involvement may be a guide that radical hysterectomy should be considered in the foreground in patients undergoing surgery. There is a need for future studies to evaluate the role of CA-125 in predicting recurrence and survival in uterine papillary serous carcinoma.