The purpose of this article was to relate pre-operative serum CA 125 to risk of nodal metastases in women with grade 1 endometrial cancer that were fully surgically staged.METHODS:
Charts were reviewed to determine all patients with pre-operative grade 1 endometrial carcinoma and a serum CA 125 undergoing complete surgical staging. Charts were also reviewed for final stage, grade, and site of metastases. All serum CA 125s were drawn within 3 weeks of definitive surgery.RESULTS:
Analysis was completed on 737 patients with grade 1 endometrial cancer. The mean age of the population was 61.9 years (95% CI 61.3–62.4). Extra uterine disease was found in 14.7% of patients and nodal disease in 12.6%. A significant difference in BMI was seen between those not having lymph node metastases (mean 38.7 kg/m2; 95% CI 38.1–39.3) and those having positive nodes (mean 35.3 kg/m2; 95% CI 34.3–36.3) (P<.001). The mean CA 125 for the cohort was 25.6 mIU/mL (95% CI 22.0–29.2). No patients with pre-operative grade 1 disease and a CA 125 <15 mIU/mL (0/239) had nodal disease at surgical staging while 18.7% (93/498) with a CA 125 >15 mIU/mL had nodal metastases (P<.001).CONCLUSION:
In patients with grade 1 endometrial adenocarcinomas, CA 125 can be used to determine who needs full surgical staging with minimal risk of missing nodal positive patients.