Pg. Rose et al., SERIAL SERUM CA-125 MEASUREMENTS FOR EVALUATION OF RECURRENCE IN PATIENTS WITH ENDOMETRIAL CARCINOMA, Obstetrics and gynecology, 84(1), 1994, pp. 12-16
Objective: To evaluate the usefulness of serum assays for CA 125 to de
tect recurrent endometrial carcinoma. Methods: Two hundred sixty-six p
atients were studied with 1101 post-treatment assays. Patients were ca
tegorized as low, medium, or high risk based on surgical-pathologic fi
ndings. CA 125 values were analyzed with respect to each patient's dis
ease status. Results: Serial CA 125 levels were elevated (greater than
35 U/mL) in 19 of 33 patients (58%) with recurrent disease. Among 236
surgically treated patients, 97 (41.1%), 42 (17.8%), and 97 (41.1%) w
ere considered low, medium, and high risk, respectively. None of the l
ow-risk and only two (4.7%) of the medium-risk patients developed recu
rrent disease. One of the latter patients was detected based on an ele
vated CA 125 level alone. Twenty-seven (27.8%) of the high-risk patien
ts developed recurrent disease, 23 of whom had elevated pre-treatment
CA 125. Fifteen of 16 (94%) with recurrent disease had an elevated CA
125 level. Nine of 12 patients with papillary serous carcinoma experie
nced recurrence; eight of these nine had elevated CA 125 levels at dia
gnosis and recurrence, in contrast to only one patient with a normal p
re-treatment level (P =.018). False elevations were noted in 13 patien
ts, 12 of whom had received radiation therapy. Conclusions: CA 125, if
elevated at diagnosis of endometrial carcinoma, is an important marke
r for recurrent disease. The use of serial CA 125 assays is most benef
icial in diagnosing recurrence in a high-risk population, including pa
tients with papillary serous carcinomas. False elevations may occur fo
llowing radiation therapy.