The relationship between serum CA-125 level and recurrence in surgical stage I endometrial cancer patients

Sep 29, 2026

Uploaded by Margaret

Early stage endometrial cancer generally carries a favorable prognosis, yet 10% to 15% of patients develop recurrence. This study assessed whether postoperative carbohydrate antigen 125 (CA-125) levels can predict recurrence risk and recurrence-free survival (RFS) in surgically staged stage I patients. Serum CA-125 was measured before surgery and 6–12 months after. Postoperative CA-125 independently predicted recurrence, with a cutoff of 13.75 U/mL.

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Abstract

1. Introduction

Abstract (Background, Methods, Results, Conclusion)

Keywords

J Chin MedAssoc ORIGINAL ARTICLE The relationship between serum CA-125 level and recurrence in surgical stage I endometrial cancer patients Hua-Hsi Wua,b,c, Hung-Tse Choua,b,c, Jen-Yu Tsenga,b,c, I-San Chana,b, Yi-Jen Chena,b,c,* aDepartment of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; bDepartment of Obstetrics and Gynecology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; cInstitute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC Abstract Background: The majority of patients diagnosed with early stage endometrial cancer have a favorable prognosis; however, approximately 10% to 15% experience a recurrence. Therefore, the aim of the present study was to evaluate whether postoperative carbohydrate antigen 125 (CA-125) levels could be used to predict recurrence and recurrence-free survival (RFS) in patients with surgical stage I endometrial cancer. Methods: We enrolled a total of 518 patients with stage I endometrial cancer who underwent surgical treatment between January 2010 and March 2019. Serum CA-125 levels were measured prior to surgery, as well as 6 to 12 months after surgery. Subsequently, the correlations between the CA-125 levels, cancer recurrence, and RFS were analyzed. Results: Although the preoperative CA-125 level was not associated with the risk of cancer recurrence, the postoperative CA-125 level was found to be the only independent predictor of recurrence in both univariate and multivariate analyses. Additionally, we found that a postoperative CA-125 cutoff value of 13.75 U/mL yielded the best sensitivity and specificity for predicting cancer recurrence. Patients with a postoperative CA-125 level ≥13 .75 U/mL, and those with a level <13 .75 U/mL, had a median time to recurrence and a 5-year RFS rate of 35.5 vs 50.5 months and 84.7 vs 94.4%, respectively. Additionally, postoperative CA-125 levels were not found to be correlated with preoperative levels. Conclusion: In patients with stage I endometrial cancer, a postoperative CA-125 level ≥13 .75 U/mL was found to be significantly correlated with a higher recurrence rate, as well as a shorter RFS. Therefore, obtaining a follow-up CA-125 level within 6 to 12 months after staging surgery may be a promising noninvasive biomarker for predicting recurrence. Keywords: Endometrial cancer; Recurrence; Serum CA-125 1. INTRODUCTION The global prevalence of endometrial cancer, which has become one of the leading gynecological malignancies, has steadily increased over the last 2 decades, with the age-standardized incidence rate increasing significantly, by 0.69% per year. This trend has been observed in most countries and territories worldwide, regardless of sociodemographic status,1 with >75% of endometrial cancers diagnosed at an early stage. The primary treatment for endometrial cancer is a combined staging surgery, which is comprised of a total hysterectomy, bilateral *Address correspondence. Dr Yi-Jen Chen, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, and Institute of Clinical Medicine, National Yang Ming Chiao Tung University, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, [ROC. E-mail address: chenyj@vghtpe.gov.tw](ROC. E-mail address: chenyj@vghtpe.gov.tw); [chenyj@nycu.edu.tw](chenyj@nycu.edu.tw)[ ](chenyj@nycu.edu.tw)(Y.-J. Chen). Conflicts of interest: Dr. Yi-Jen Chen, an editorial board member at Journal of the Chinese Medical Association, had no role in the peer review process of or decision to publish this article. The other authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article. Journal of Chinese Medical Association. (2023) 86: 1001-1007. Received November 11, 2022; accepted June 11, 2023. doi: 10. 1097/JCMA.0000000000000985 Copyright © 2023, the Chinese Medical Association. This is an open access article under the

FAQs

What was the purpose of measuring CA-125 in stage I endometrial cancer patients?

To determine whether postoperative CA-125 levels could predict cancer recurrence and recurrence-free survival (RFS) after surgical staging.

How many patients were included, and when were CA-125 levels measured?

A total of 518 patients were enrolled. Serum CA-125 was measured before surgery and again 6 to 12 months after surgery.

What CA-125 cutoff was identified for predicting recurrence, and what did it indicate?

A postoperative CA-125 cutoff value of 13.75 U/mL gave the best sensitivity and specificity. Patients with levels ≥13.75 U/mL had a shorter time to recurrence and lower 5-year RFS than those below the cutoff.

Sep 29, 2026

Uploaded by Margaret