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Significance of preoperative serum CA-125 levels in the prediction of lymph node metastasis in epithelial ovarian cancer.
Acta Obstet Gynecol Scand. 2008; 87(11):1136-42.AO

Abstract

OBJECTIVE

To investigate preoperative serum CA-125 levels as a predictive factor for evaluation of lymph node metastasis in epithelial ovarian cancer.

DESIGN

Retrospective study.

SETTING

Medical records at Seoul National University Hospital.

POPULATION

Ninety-nine patients with epithelial ovarian cancer between January 2004 and March 2007.

METHODS

The significance of the preoperative serum CA-125 level for the prediction of lymph node metastasis was determined using the receiver operating characteristic (ROC) curve, McNemar's test and logistic regression analysis. Clinical prognostic factors affecting survival were evaluated using the Kaplan-Meier analysis with the log-rank test and Cox's proportional hazard analysis.

RESULTS

The ROC curve showed the best cut-off value (535 U/mL) of the preoperative serum CA-125 level with regard to sensitivity (70.0%) and specificity (83.1%). Imaging studies combined with the preoperative serum CA-125 level showed the highest sensitivity (90.0%), whereas imaging studies alone showed the highest specificity (89.8%) for the prediction of lymph node metastasis. FIGO stage III-IV, the preoperative serum CA-125 level (> or =535 U/mL) and lymph node involvement on imaging studies were significant factors for the prediction of lymph node metastasis (p<0.05). Suboptimal debulking surgery and lymph node metastasis were poor prognostic factors for progression-free survival and overall survival, respectively (p<0.05).

CONCLUSIONS

The preoperative serum CA-125 level (> or =535 U/mL) may be important for the prediction of lymph node metastasis in patients with epithelial ovarian cancer. Furthermore, it can be helpful in selecting patients who should undergo systemic lymphadenectomy for the detection of hidden lymph node metastasis.

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Authors+Show Affiliations

Kim HS
Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Park NH
No affiliation info available
Chung HH
No affiliation info available
Kim JW
No affiliation info available
Song YS
No affiliation info available
Kang SB
No affiliation info available

MeSH

AdultAgedBiomarkers, TumorCA-125 AntigenFemaleHumansKaplan-Meier EstimateLogistic ModelsLymph Node ExcisionLymph NodesLymphatic MetastasisMiddle AgedNeoplasm StagingNeoplasms, Glandular and EpithelialOvarian NeoplasmsPredictive Value of TestsPrognosisProportional Hazards ModelsROC CurveRetrospective StudiesSensitivity and SpecificityYoung Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18951217

Citation

Kim, Hee Seung, et al. "Significance of Preoperative Serum CA-125 Levels in the Prediction of Lymph Node Metastasis in Epithelial Ovarian Cancer." Acta Obstetricia Et Gynecologica Scandinavica, vol. 87, no. 11, 2008, pp. 1136-42.
Kim HS, Park NH, Chung HH, et al. Significance of preoperative serum CA-125 levels in the prediction of lymph node metastasis in epithelial ovarian cancer. Acta Obstet Gynecol Scand. 2008;87(11):1136-42.
Kim, H. S., Park, N. H., Chung, H. H., Kim, J. W., Song, Y. S., & Kang, S. B. (2008). Significance of preoperative serum CA-125 levels in the prediction of lymph node metastasis in epithelial ovarian cancer. Acta Obstetricia Et Gynecologica Scandinavica, 87(11), 1136-42. https://doi.org/10.1080/00016340802478158
Kim HS, et al. Significance of Preoperative Serum CA-125 Levels in the Prediction of Lymph Node Metastasis in Epithelial Ovarian Cancer. Acta Obstet Gynecol Scand. 2008;87(11):1136-42. PubMed PMID: 18951217.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Significance of preoperative serum CA-125 levels in the prediction of lymph node metastasis in epithelial ovarian cancer. AU - Kim,Hee Seung, AU - Park,Noh Hyun, AU - Chung,Hyun Hoon, AU - Kim,Jae Weon, AU - Song,Yong Sang, AU - Kang,Soon Beom, PY - 2008/10/28/pubmed PY - 2008/12/30/medline PY - 2008/10/28/entrez SP - 1136 EP - 42 JF - Acta obstetricia et gynecologica Scandinavica JO - Acta Obstet Gynecol Scand VL - 87 IS - 11 N2 - OBJECTIVE: To investigate preoperative serum CA-125 levels as a predictive factor for evaluation of lymph node metastasis in epithelial ovarian cancer. DESIGN: Retrospective study. SETTING: Medical records at Seoul National University Hospital. POPULATION: Ninety-nine patients with epithelial ovarian cancer between January 2004 and March 2007. METHODS: The significance of the preoperative serum CA-125 level for the prediction of lymph node metastasis was determined using the receiver operating characteristic (ROC) curve, McNemar's test and logistic regression analysis. Clinical prognostic factors affecting survival were evaluated using the Kaplan-Meier analysis with the log-rank test and Cox's proportional hazard analysis. RESULTS: The ROC curve showed the best cut-off value (535 U/mL) of the preoperative serum CA-125 level with regard to sensitivity (70.0%) and specificity (83.1%). Imaging studies combined with the preoperative serum CA-125 level showed the highest sensitivity (90.0%), whereas imaging studies alone showed the highest specificity (89.8%) for the prediction of lymph node metastasis. FIGO stage III-IV, the preoperative serum CA-125 level (> or =535 U/mL) and lymph node involvement on imaging studies were significant factors for the prediction of lymph node metastasis (p<0.05). Suboptimal debulking surgery and lymph node metastasis were poor prognostic factors for progression-free survival and overall survival, respectively (p<0.05). CONCLUSIONS: The preoperative serum CA-125 level (> or =535 U/mL) may be important for the prediction of lymph node metastasis in patients with epithelial ovarian cancer. Furthermore, it can be helpful in selecting patients who should undergo systemic lymphadenectomy for the detection of hidden lymph node metastasis. SN - 1600-0412 UR - https://www.unboundmedicine.com/medline/citation/18951217/Significance_of_preoperative_serum_CA_125_levels_in_the_prediction_of_lymph_node_metastasis_in_epithelial_ovarian_cancer_ L2 - https://doi.org/10.1080/00016340802478158 DB - PRIME DP - Unbound Medicine ER -