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- Title
Patterns of metastasis and recurrence in premenopausal women with low-risk endometrial cancer but elevated CA125.
- Authors
Kidong Kim; Ala Aiob; Jong-Min Song; Kwang Beom Lee; Sokbom Kang; Chae Hyeong Lee; Se Ik Kim; Nam Kyeong Kim; Dae Hoon Jeong
- Abstract
Objective: Women with low-risk endometrial cancer, defined by the Korean Gynecologic Oncology Group (KGOG) criteria, have a low risk of lymph node metastasis and an excellent prognosis without lymphadenectomy. However, it is unclear whether lymphadenectomy should be performed in premenopausal women who meet KGOG criteria other than elevated cancer antigen 125 (CA125) because CA125 can be elevated by benign conditions such as endometriosis. We investigated the pattern of metastasis and recurrence to assess the value of lymphadenectomy in this population. Methods: Premenopausal women with endometrial cancer meeting KGOG criteria undergoing hysterectomy between January 2013 and December 2021, endometrioid histology, less than half myometrial invasion and no extra-corporeal tumor spread on imaging, elevated CA125 (>35 IU/ml) were included. Characteristics were collected from seven institutes in the Republic of Korea by medical record review. Recurrence-free survival (RFS) was estimated using the Kaplan-Meier method and compared using the log-rank test. Results: Seventy-three patients were included in this analysis. Of 62 women who underwent lymphadenectomy, only two women (3.2%) had lymph node metastasis. Eighteen women (24.7%) received adjuvant therapy. At a median follow-up of 59 months, the 5-year RFS was 88.8%. Five women (7%) experienced recurrence: 2 had lymph node recurrence, and the other 3 had non-nodal recurrence. RFS was similar between women who underwent lymphadenectomy and those who did not (p=0.737). Conclusion: Premenopausal women who had elevated CA125 but met all other KGOG criteria showed a low risk of lymph node metastasis and recurrence and a good prognosis. Lymphadenectomy can be omitted in this population.
- Subjects
SOUTH Korea; ENDOMETRIAL cancer; CANCER relapse; LYMPHATIC metastasis; METASTASIS; LYMPHOCELE; GYNECOLOGIC oncology; ENDOMETRIAL tumors
- Publication
Journal of Gynecologic Oncology, 2024, Vol 35, p38
- ISSN
2005-0380
- Publication type
Article
- DOI
10.3802/jgo.2024.35.S2.P35