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REVIEW article

Front. Oncol.
Sec. Cancer Epidemiology and Prevention
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1442814
This article is part of the Research Topic The Future of Cancer Surveillance Research View all 19 articles

Evaluating Pretreatment Serum CA-125 Levels as Prognostic Biomarkers in Endometrial Cancer: A Comprehensive Meta-Analysis

Provisionally accepted
Zhong Yu Zhong Yu Yue Sun Yue Sun Cuishan Guo Cuishan Guo *
  • Department of Obstetrics and Gynecology, Sheng Jing Hospital Affiliated, China Medical University, Shenyang, Liaoning Province, China

The final, formatted version of the article will be published soon.

    In recent years, the incidence of endometrial cancer (EC) has been rising. This metaanalysis aims to clarify the prognostic significance of serum CA-125 levels in EC.Articles up to March 1, 2024, were systematically searched in EMBASE, Cochrane Library, PubMed, and Web of Science. This analysis pooled hazard ratios (HR) and 95% confidence intervals (CI) from qualifying studies to evaluate the association of CA-125 levels with overall survival (OS), progression-free survival (PFS), diseasefree/relapse-free survival (DFS/RFS), and disease-specific survival (DSS).25 studies involving 7,716 patients were included. The analysis revealed that elevated CA-125 levels correlate with poorer OS (HR = 1.848, 95% CI: 1.571-2.175, p < 0.001). This association persisted across various study regions and sample sizes, and was notably strong in subgroups with a CA-125 cut-off value of less than 35 (HR = 2.07, 95% CI: 1.13-3.80, p = 0.019) and equal to 35 (HR = 2.04, 95% CI: 1.49-2.79, p < 0.001), and among type II pathology patients (HR = 1.72, 95% CI: 1.07-2.77, p = 0.025). Similarly, high CA-125 levels were linked to reduced PFS, particularly in subgroups with a CA-125 cut-off value less than 35 (HR = 1.87, 95% CI: 1.15-3.04, p = 0.012) and equal to 35 (HR = 4.94, 95% CI: 2.56-9.54, p < 0.001), and in endometrioid endometrial cancer patients (HR = 2.28, 95% CI: 1.18-4.40, p = 0.014).Elevated CA-125 levels were also indicative of worse DFS/RFS (HR = 2.17, 95% CI:1.444-3.262, p < 0.001) and DSS (HR = 2.854; 95% CI: 1.970-4.133, p < 0.001).Serum CA-125 levels before treatment was highly associated with prognosis of EC patients.

    Keywords: endometrial cancer, CA-125, prognosis, surv ival, Meta - analysis

    Received: 03 Jun 2024; Accepted: 28 Aug 2024.

    Copyright: © 2024 Yu, Sun and Guo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Cuishan Guo, Department of Obstetrics and Gynecology, Sheng Jing Hospital Affiliated, China Medical University, Shenyang, 110004, Liaoning Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.