Panyavaranant P, Manchana T. Preoperative markers for the prediction of high-risk features in endometrial cancer. World J Clin Oncol 2020; 11(6): 378-388 [PMID: 32874951 DOI: 10.5306/wjco.v11.i6.378]
Corresponding Author of This Article
Tarinee Manchana, MD, Associate Professor, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, 1873, Rama IV Road, Patumwan, Bangkok 10330, Thailand. tarinee.m@chula.ac.th
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Jun 24, 2020; 11(6): 378-388 Published online Jun 24, 2020. doi: 10.5306/wjco.v11.i6.378
Preoperative markers for the prediction of high-risk features in endometrial cancer
Pinyada Panyavaranant, Tarinee Manchana
Pinyada Panyavaranant, Tarinee Manchana, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
Author contributions: Panyavaranant P designed the research study, analyzed the data and wrote the manuscript; Manchana T designed the research study, collected data and revised the final manuscript.
Informed consent statement: Patients were not required to give informed consent because data collection and analysis were performed retrospectively.
Conflict-of-interest statement: All the authors have no conflicts of interest.
Data sharing statement: No additional data are available.
STROBE statement: The author has read the STROBE checklist and prepared the manuscript accordingly.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Tarinee Manchana, MD, Associate Professor, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, 1873, Rama IV Road, Patumwan, Bangkok 10330, Thailand. tarinee.m@chula.ac.th
Received: December 20, 2019 Peer-review started: December 20, 2019 First decision: April 2, 2020 Revised: May 11, 2020 Accepted: June 2, 2020 Article in press: June 2, 2020 Published online: June 24, 2020 Processing time: 187 Days and 8.9 Hours
Core Tip
Core tip: Standard surgical treatment in endometrial cancer consists of hysterectomy with bilateral salpingo-oophorectomy. Node dissection is performed in selected patients with high-risk features such as grade 3 tumors, large tumor sizes (more than 2 cm), deep myometrial invasion (more than 50%), lymphovascular space invasion, cervical involvement, and extrauterine involvement. Preoperative cancer antigen 125 (CA125) and human epididymis protein 4 (HE4) levels were significantly elevated in clinical stage 1 postmenopausal endometrial cancer patients with these high-risk features and an increased risk of upstaging. CA125 levels above 20 U/mL and HE4 levels above 113 pmol/L were used as the optimal cut-off values for the prediction of high-risk features, and they were also shown to be poor prognostic factors. Preoperative CA125 and HE4 may be an acceptable screening test for general gynecologists to consider the referral of these high-risk patients to gynecologic oncologists to perform complete surgical staging.
