CA 125 may not reflect disease status in patients with uterine serous carcinoma

• Published in: Cancer 1998-05, Vol.82 (9), p.1720-1725
• Main Authors: Price, Fredric V., Chambers, Setsuko K., Carcangiu, Maria Luisa, Kohorn, Ernest I., Schwartz, Peter E., Chambers, Joseph T.
• Format: Article
• Language: English
• Subjects: Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Biomarkers, Tumor - blood; CA 125; CA-125 Antigen - blood; chemotherapy; Chemotherapy, Adjuvant; Combined Modality Therapy; Cystadenocarcinoma, Serous - blood; Cystadenocarcinoma, Serous - drug therapy; Cystadenocarcinoma, Serous - surgery; endometrial carcinoma; Endometrial Neoplasms - blood; Endometrial Neoplasms - drug therapy; Endometrial Neoplasms - surgery; Endometrium; Female; Female genital diseases; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; Neoplasm Metastasis; Neoplasm Recurrence, Local - blood; Predictive Value of Tests; tumor markers; Tumors; uterine carcinoma; uterine serous carcinoma
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/(SICI)1097-0142(19980501)82:9<1720::AID-CNCR19>3.0.CO;2-6

BACKGROUND Although CA 125 level correlates with response to therapy in patients with serous carcinoma of the ovary, the utility of CA 125 in patients with high risk or metastatic endometrial carcinoma has not been established. METHODS CA 125 was tested as a marker of disease status in patients with endometrial serous carcinoma (SC) undergoing adjuvant chemotherapy. All patients received monthly intravenous chemotherapy with cisplatin, cyclophosphamide, and doxorubicin at standard doses (median number of courses, 6; range, 2‐8 courses). Serum CA 125 was measured at diagnosis and before each course. After the completion of chemotherapy, patients were examined every 3 months and the CA 125 level was measured. RESULTS A total of 220 serum specimens from 15 patients with invasive SC were analyzed. All five patients who died of disease had clinical or radiographic evidence of tumor, which CA 125 elevation did not precede or predict. One patient with advanced disease at staging never had an elevated CA 125 level but died of disseminated disease 14 months after diagnosis. At last follow‐up, 3 patients who were without evidence of disease > 36 months from diagnosis had significant false‐positive elevations in their CA 125 level (>50 u/mL) lasting 1, 2, and 4 months, respectively, during therapy. The sensitivity for advanced disease was only 57% at presentation. CONCLUSIONS CA 125 may reflect advanced stage disease and portend a poor prognosis, but may not add information to that gained by history and physical examination, preoperative studies, or surgery that already is mandated by this high risk histology. This circulating marker appears to have limited utility in monitoring the effects of adjuvant therapy for SC, and may not predict recurrence in the absence of other clinical findings. Cancer 1998;82:1720‐5. © 1998 American Cancer Society. CA 125 has been advocated as a marker of subclinical endometrial carcinoma, but did not add to other information available at the time of surgical staging or during clinical surveillance in this group of high risk patients.