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Predictive value of preoperative serum CA-125 levels in patients with uterine cancer: The Asian experience 2000 to 2012

OBJECTIVE: Much of the early investigative work on the usefulness of preoperative serum CA-125 levels in identifying patients with early-stage endometrial carcinoma who have occult metastases were carried out in Europe and the United States. This article reviews CA-125 as a possible index for determ...

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Autores principales: Patsner, Bruce, Yim, Ga Won
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Obstetrics and Gynecology; Korean Society of Contraception and Reproductive Health; Korean Society of Gynecologic Endocrinology; Korean Society of Gynecologic Endoscopy and Minimal Invasive Surgery; Korean Society of Maternal Fetal Medicine; Korean Society of Ultrasound in Obstetrics and Gynecology 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3784131/
https://www.ncbi.nlm.nih.gov/pubmed/24328017
http://dx.doi.org/10.5468/ogs.2013.56.5.281
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author Patsner, Bruce
Yim, Ga Won
author_facet Patsner, Bruce
Yim, Ga Won
author_sort Patsner, Bruce
collection PubMed
description OBJECTIVE: Much of the early investigative work on the usefulness of preoperative serum CA-125 levels in identifying patients with early-stage endometrial carcinoma who have occult metastases were carried out in Europe and the United States. This article reviews CA-125 as a possible index for determining the need for full surgical staging, from the results of large medical centers in Asia, particularly Taiwan and Korea. METHODS: A Medline search was performed using CA-125 and endometrial cancer as index words from 1981 to 2012. Those publications felt to be the most important especially from institutions from Asia since 2000 were identified in this review. RESULTS: Most articles that analyzed the utility of serum CA-125 levels as predictive marker for disease extent or prognosis in uterine cancer used univariate and multivariable logistic regression analysis, and performed receiver operative curves to find the best cut-off values. The main factor of interest was whether clinicians can stratify patients that need lymphadenectomy in early stage disease. Suggested optimal cut-off value ranged from 20 to 210 U/mL. Not only preoperative CA-125 level, but myometrial invasion status by magnetic resonance imaging was the most significant combined parameter for predicting disease extent. CONCLUSION: Elevated CA-125 in patients with apparent early-stage disease is clearly a risk factor for the presence of extra-uterine disease although the optimal cut-off levels vary. The evolution of clinical investigations over the past decade, particularly in Asia, suggests employment of the test in a more focused manner to identify high risk patients preoperatively.
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spelling pubmed-37841312013-12-10 Predictive value of preoperative serum CA-125 levels in patients with uterine cancer: The Asian experience 2000 to 2012 Patsner, Bruce Yim, Ga Won Obstet Gynecol Sci Review OBJECTIVE: Much of the early investigative work on the usefulness of preoperative serum CA-125 levels in identifying patients with early-stage endometrial carcinoma who have occult metastases were carried out in Europe and the United States. This article reviews CA-125 as a possible index for determining the need for full surgical staging, from the results of large medical centers in Asia, particularly Taiwan and Korea. METHODS: A Medline search was performed using CA-125 and endometrial cancer as index words from 1981 to 2012. Those publications felt to be the most important especially from institutions from Asia since 2000 were identified in this review. RESULTS: Most articles that analyzed the utility of serum CA-125 levels as predictive marker for disease extent or prognosis in uterine cancer used univariate and multivariable logistic regression analysis, and performed receiver operative curves to find the best cut-off values. The main factor of interest was whether clinicians can stratify patients that need lymphadenectomy in early stage disease. Suggested optimal cut-off value ranged from 20 to 210 U/mL. Not only preoperative CA-125 level, but myometrial invasion status by magnetic resonance imaging was the most significant combined parameter for predicting disease extent. CONCLUSION: Elevated CA-125 in patients with apparent early-stage disease is clearly a risk factor for the presence of extra-uterine disease although the optimal cut-off levels vary. The evolution of clinical investigations over the past decade, particularly in Asia, suggests employment of the test in a more focused manner to identify high risk patients preoperatively. Korean Society of Obstetrics and Gynecology; Korean Society of Contraception and Reproductive Health; Korean Society of Gynecologic Endocrinology; Korean Society of Gynecologic Endoscopy and Minimal Invasive Surgery; Korean Society of Maternal Fetal Medicine; Korean Society of Ultrasound in Obstetrics and Gynecology 2013-09 2013-09-14 /pmc/articles/PMC3784131/ /pubmed/24328017 http://dx.doi.org/10.5468/ogs.2013.56.5.281 Text en Copyright © 2013 Korean Society of Obstetrics and Gynecology http://creativecommons.org/licenses/by-nc/3.0/ Articles published in Obstet Gynecol Sci are open-access, distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
Patsner, Bruce
Yim, Ga Won
Predictive value of preoperative serum CA-125 levels in patients with uterine cancer: The Asian experience 2000 to 2012
title Predictive value of preoperative serum CA-125 levels in patients with uterine cancer: The Asian experience 2000 to 2012
title_full Predictive value of preoperative serum CA-125 levels in patients with uterine cancer: The Asian experience 2000 to 2012
title_fullStr Predictive value of preoperative serum CA-125 levels in patients with uterine cancer: The Asian experience 2000 to 2012
title_full_unstemmed Predictive value of preoperative serum CA-125 levels in patients with uterine cancer: The Asian experience 2000 to 2012
title_short Predictive value of preoperative serum CA-125 levels in patients with uterine cancer: The Asian experience 2000 to 2012
title_sort predictive value of preoperative serum ca-125 levels in patients with uterine cancer: the asian experience 2000 to 2012
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3784131/
https://www.ncbi.nlm.nih.gov/pubmed/24328017
http://dx.doi.org/10.5468/ogs.2013.56.5.281
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