CA-125 MAY NOT REFLECT DISEASE STATUS IN PATIENTS WITH UTERINE SEROUSCARCINOMA

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 s tatus in patients with endometrial serous carcinoma (SC) undergoing ad juvant chemotherapy. All patients received monthly intravenous chemoth erapy with cisplatin, cyclophosphamide, and doxorubicin at standard do ses (median number of courses, 6; range, 2-8 courses). Serum CA 125 wa s measured at diagnosis and before each course. After the completion o f chemotherapy, patients were examined every 3 months and the CA 125 l evel was measured. RESULTS. A total of 220 serum specimens from 15 pat ients with invasive SC were analyzed. All five patients who died of di sease had clinical or radiographic evidence of tumor, which CA 125 ele vation did not precede or predict. One patient with advanced disease a t staging never had an elevated CA 125 level but died of disseminated disease 14 months after diagnosis. At last follow-up, 3 patients who w ere without evidence of disease > 36 months from diagnosis had signifi cant false-positive elevations in their CA 125 level (>50 u/mL) lastin g 1, 2, and 4 months, respectively, during therapy. The sensitivity fo r advanced disease was only 57% at presentation. CONCLUSIONS, CA 125 m ay reflect advanced stage disease and portend a poor prognosis, but ma y not add information to that gained by history and physical examinati on, preoperative studies, or surgery that already is mandated by this high risk histology. This circulating marker appears to have limited u tility in monitoring the effects of adjuvant therapy for SC, and may n ot predict recurrence in the absence of other clinical findings. (C) 1 998 American Cancer Society.