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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Gynecological Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1510988

Prognosis of premenopausal women with low-risk endometrial cancer but elevated CA125 levels

Provisionally accepted
Jeong Min Song Jeong Min Song 1Ala Aiob Ala Aiob 2*Kidong Kim Kidong Kim 3,4*Kwang Beom Lee Kwang Beom Lee 5*Sokbom Kang Sokbom Kang 6*Chae Hyeong Lee Chae Hyeong Lee 7Se Ik Kim Se Ik Kim 4Nam Kyeong Kim Nam Kyeong Kim 3*Dae Hoon Jeong Dae Hoon Jeong 8*
  • 1 Department of Obstetrics and Gynecology, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
  • 2 Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya, Israel
  • 3 Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi, Republic of Korea
  • 4 Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, Seoul, Republic of Korea
  • 5 Department of Obstetrics and Gynecology, Gachon University Gil Medical Center, Incheon, Republic of Korea
  • 6 Center for Gynecologic Cancer, National Cancer Center, Goyang, Republic of Korea
  • 7 Department of Obstetrics and Gynecology, Graduate School of Medicine, Dongguk University Seoul, Seoul, Seoul, Republic of Korea
  • 8 Busan Paik Hospital, Paik Institute for Clinical Research, Inje University, Busan, Republic of Korea

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

    Women with low-risk endometrial cancer, as 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 the KGOG criteria other than elevated cancer antigen 125 (CA125) levels, because the CA125 level can be elevated by benign conditions. We investigated the patterns of metastasis and recurrence to assess the value of lymphadenectomy in this population.Methods: Premenopausal women with endometrial cancer meeting the KGOG criteria, except for those with elevated CA125 levels, were eligible. The characteristics of the eligible women were collected from seven institutes in the Republic of Korea by reviewing their medical records. Recurrence-free survival (RFS) was estimated using the Kaplan-Meier method and compared using the log-rank test.Results: Seventy-three patients were included. Of 62 women who underwent lymphadenectomy, only two (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, two had lymph node recurrence, and three had non-nodal recurrence. RFS was similar between the women who did and did not undergo lymphadenectomy (P=0.737).Premenopausal women who had elevated CA125 levels but met all other KGOG criteria showed a low risk of lymph node metastasis and recurrence as 4 4 well as a good prognosis. Therefore, lymphadenectomy can be omitted in this population.

    Keywords: Endometrial cancer, Lymphadenectomy, CA125, Premenopausal * Non atypical hyperplasia, ** excluding 11 patients without lymph node removal CCRT, concurrent chemoradiation therapy, CA125, cancer antigen 125, SD, standard deviation, BMI, body mass index, LN, lymph node, FIGO, 2009 International Federation of Gynecology and Obstetrics

    Received: 14 Oct 2024; Accepted: 26 Dec 2024.

    Copyright: © 2024 Song, Aiob, Kim, Lee, Kang, Lee, Kim, Kim and Jeong. 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:
    Ala Aiob, Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya, Israel
    Kidong Kim, Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam-si, 13620, Gyeonggi, Republic of Korea
    Kwang Beom Lee, Department of Obstetrics and Gynecology, Gachon University Gil Medical Center, Incheon, Republic of Korea
    Sokbom Kang, Center for Gynecologic Cancer, National Cancer Center, Goyang, Republic of Korea
    Nam Kyeong Kim, Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam-si, 13620, Gyeonggi, Republic of Korea
    Dae Hoon Jeong, Busan Paik Hospital, Paik Institute for Clinical Research, Inje University, Busan, Republic of Korea

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