Investigation of the Role of Preoperative Serum CA 125 Levels in Determining the Necessity of Lymphadenectomy in Cases Diagnosed with Endometrium Cancer: A Retrospective Study

Abstract

Objective: The aim of this study is to investigate the relationship between preoperative serum CA 125 levels and clinicopathological parameters in patients operated for endometrial carcinoma (EC) and to reveal the effectiveness of preoperative serum CA 125 levels in determining the necessity of lymphadenectomy. Materials and Methods: The study included retrospective data of 88 patients who underwent surgery due to EC. The relationship between the patients' preoperative serum tumor marker CA-125 levels and tumor grade, stage, histological type, lymph node positivity was evaluated statistically. The statistical significance of CA-125 levels in determining the need for lymph node dissection was analyzed. Results: When the preoperative diagnostic methods of the cases were evaluated according to their surgical stage; the mean CA 125 value was 31.21±35.54 (4.4-150.3) IU/ml in early stage (Stage I-II) patients and 349.13±497.34 (19.5-1566) IU/ml in advanced stage (Stage III-IV) patients (p=0.001). Considering the depth of myometrial invasion and preoperative CA 125 values, the mean preoperative CA 125 values were 21.43±20.06 (4.4-44.1) IU/ml in cases with myometrial invasion less than 1/2, while this value was 141.03±329.47 (6.8-1566) IU/ml in cases with more than 1/2 and the difference between the groups was found to be statistically significant (p=0.025). CA 125 levels of cases with positive lymph nodes were statistically significantly higher than CA 125 levels of cases with negative lymph nodes (p<0.05). While the CA 125 level was 35 IU/ml and above in all cases with positive lymph nodes, the CA 125 level was 35 IU/ml and above in 30.2% of the cases with negative lymph nodes (p<0.05). Conclusions: The results we obtained in this study support the association of increased preoperative CA 125 levels with lymph node positivity, advanced stage and myometrial involvement above ½ in cases with EC.