Prognostic Significance of Preoperative Serum CA125, CA19-9, CA72-4, CEA, and AFP in Patients With Endometrial Cancer

Abstract Objective: To determine the factors related to overall survival (OS) and progression-free survival (PFS) in endometrial cancer (EC) patients.Materials and methods: A retrospective cohort study of 906 EC patients was conducted at Shengjing Hospital, China Medical University. Baseline information about the patients, tumor characteristics, and data on five serum biomarkers (CA125, CA19-9, CA72-4, CEA, and AFP) were collected. Groups and their survival rates were compared using log-rank tests and Kaplan-Meier analysis, respectively. Hazard ratios (HRs) and 95% confidence intervals (CIs) were determined using univariate or multivariate Cox proportional hazard models. The outcome measures used were OS, defined as the time between surgery and death or last follow-up for surviving patients, and PFS, defined as the time from the completion of initial surgery to either first progression, disease recurrence, or death.Results: Multivariate analysis showed lower PFS associated with age ≥ 66 years (P < 0.001), type II histology (P = 0.015), low degree of tumor differentiation (P = 0.004), and FIGO stage III & IV (P = 0.002). Elevated CA125 (P = 0.042) and AFP (P = 0.016) were identified as independent biomarkers for PFS. Increased CA125 (P = 0.013), age ≥ 66 years (P < 0.001), type II histology (P＜0.001), and FIGO stage III & IV (P = 0.015) were independent factors associated with OS. Analysis of the CA125 sub-group showed that individuals with elevated CA125 andAFP (P = 0.049) had significantly lower PFS. Conclusion: This study suggests that CA125 and AFP are prognostic biomarkers for EC.