2022-RA-1449-ESGO The prognostic value of serum CA125 and HE4 in endometrial cancers stratified by molecular subgroup. (20th October 2022)

• Record Type: Journal Article
• Authors: Barr, Chloe Evelyn; Wan, Louise; Quille, Nomondary; Brown, Matthew; Kedzierska, Katarzyna; Church, David; Edmondson, Richard; Crosbie, Emma Jane
• Is Part Of: International journal of gynecological cancer. Volume 32(2022)Supplement 2
• Page Start: A416
• Page End: A417
• Publication Date: 2022-10-20
• Subjects: Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-2022-ESGO.893
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Introduction/Background: Endometrial cancer is the commonest gynaecological malignancy. Molecular classification informs prognosis, however markers that further risk-stratify intermediate groups are needed. Serum cancer antigen-125 (CA125) and human epididymis-4 (HE4) show promise as prognostic markers. The aim of this study was to evaluate the association between serum CA125, HE4 and endometrial cancer survival outcomes when stratified by molecular subgroup. Methodology: Pre-treatment serum CA125 and HE4 levels were measured and endometrial tumours classified according to WHO molecular classification. The relationship between biomarkers and survival was evaluated using Kaplan-Meier analysis and multivariable cox regression. Results: Overall, 327 women were included, with POLE status available for 216. Tumours were POLE-mutant (5%), p53-abnormal (11%), MMR-deficient (30%) and NSMP (54%). Median follow up was 50 months (IQR 30–60), during which 42 (13%) recurred and 71 (21%) women died. CA125≥35U/mL was independently associated with overall mortality [aHR=2.42 (95%CI:1.45–4.06), p=0.001), cancer specific death [aHR=2.00 (95%CI:1.04–3.87), p=0.04] and recurrence [aHR=2.69 (95%CI:1.38–5.27), p=0.004]. When stratified by molecular subgroup, CA125≥35U/mL and HE4≥150pmol/L were prognostic of overall survival in MMR-deficient [CA125: aHR=4.92 (95%CI:1.74–13.89), p=0.003 and HE4: aHR=4.03 (95%CI:1.34–12.11), p=0.01] and NSMP subgroups [CA125: aHR=3.72 (95%CI:1.30–10.67), p=0.01)]. Conclusion: CA125 and HE4 may risk-stratify those at intermediate risk of recurrence and death. Evaluation in a larger population is required.