International Journal of Cancer and Clinical Research Research Article: Open Access ClinMed International Library Citation: Hegazy MW, Elsawy WH, Tolba A, Shoukri M (2016) Cancer Antigen 125 Levels can be Used as a Tumor Marker for Monitoring Patients with Endometrial Serous Carcinoma?. Int J Cancer Clin Res 3:075 Received: October 31, 2016: Accepted: November 28, 2016: Published: December 01, 2016 Copyright: © 2016 Hegazy MW, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hegazy et al. Int J Cancer Clin Res 2016, 3:075 ISSN: 2378-3419 Volume 3 | Issue 6 Cancer Antigen 125 Levels can be Used as a Tumor Marker for Moni- toring Patients with Endometrial Serous Carcinoma? MW Hegazy 1,2 *, Wael H Elsawy 2 , A Tolba 3 and M Shoukri 4 1 Department of Radiation Oncology, King Faisal Specialist Hospital & Research Center, Saudi Arabia 2 Department of Clinical Oncology & Nuclear Medicine, Zagazig Faculty of Medicine, Egypt 3 Department of pathology, King Faisal Specialist Hospital & Research Center, Saudi Arabia 4 Department of Cell biology & Biotechnology, King Faisal Specialist Hospital & Research Center, Saudi Arabia *Corresponding author: Mohamed W Hegazy, Department of Radiation Oncology, King Faisal Specialist Hospital & Research Center, Kingdom of Saudi Arabia, PO Box 3354, Riyadh 11211 MBC 64, Saudi Arabia, Tel: 966550742859, E-mail: mhegazy@kfshrc.edu.sa than type I tumors. While they comprise 10-20% of endometrial carcinomas, they account for 40% of deaths from the disease [3-5]. USAC may develop from endometrial intraepithelial carcinoma (EIC), a lesion related to malignant transformation of the endometrial surface epithelium, against a background of endometrial atrophy [6,7]. However, EIC was commonly found in association with extrauterine serous carcinoma, with both sites having identical clones of p53 mutations [8]. Tis fnding suggests that EIC represents an early form of USAC rather than its true precursor [9]. A relatively new entity, “endometrial glandular dysplasia”, which histologically bridges benign endometrium and EIC, may be the putative precursor lesion to USC [10]. USAC is a more aggressive histologic variant of malignant epithelial tumors, with a higher incidence of extrauterine disease at presentation [11-13]. Serous adenocarcinoma is considered high grade by default, although it is staged using the same FIGO/AJCC staging system as endometrial cancers [14]. Both the NCCN panel and the SGO recommended that CA-125 and MRI/CT may be useful before surgery to assess if extrauterine disease is present; PET may also be useful. Patterns of failure ofen mimic those of ovarian cancer [11]. Multimodality therapy is typically recommended for this tumors [15,16]. Optimal cytoreduction and adjuvant platinum/taxane- based chemotherapy appear to improve survival, while adjuvant radiotherapy may contribute to loco-regional disease control [11]. Te 5-year survival rate for all stages of USAC is only 53% compared with 83% for endometrioid carcinoma [17]. Several studies have shown a correlation between preoperative levels of CA- 125 and presence of extrauterine disease at the time of surgery as well as advanced stage and survival in women with USAC [18-21]. Serum CA-125 levels in USAC have been assessed in many previous studies [19-26] and their surveillance may be a useful indicator of disease response or progression [19,26]. Te aim of our study was to evaluate the clinical signifcance of rising CA-125 levels in patients with USAC. Abstract Aim: To determine the levels of CA-125 preoperative, postoperative and during follow up of patients with uterine serous adenocarcinoma (USAC) and evaluate its role as a tumor marker or not in these patients by its level changes on staging, cure and recurrence. Methods: Database was reviewed for all USAC patients. Thirty three patients who were treated and had serial CA-125 (normal level up to 35 U/ml) from 2007 to 2014 at our institution were included in this study. Results: With mean follow up of 26 months, there are 7 patients with initial normal CA-125 with only intrauterine disease and 26 patients with initial high CA-125 with extrauterine disease (p value 0.024). Mean follow up of early stage was 42 months while late stage was 20 months (p 0.019).With doubling levels of CA-125, there was a statistical signifcant effect on follow up period (p 0.027). In early stage, 3 out of 9 patients had recurrence; while 13 out of 17 patients in advanced stage, post therapy after normalization of CA-125 (p = 0.04), all recurrent cases had high CA-125 (p < 0.001). Conclusion: Our study with these fndings showed that preoperative and serial levels of serum CA-125 correlate with disease stage, follow up period and may be having clinical signifcant and preceding disease recurrence and /or progression. Keywords CA125, Endometrial serous carcinoma Background Uterine cancer is the most common malignancy of the female genital tract in the United States [1], a situation which is similar at our institution [2]. Endometrial adenocarcinoma is the most common type of uterine cancer. Endometrial cancer is classifed into two subtypes (I and II), which refect general characteristics of its clinicopathological spectrum. Uterine serous adenocarcinoma (USAC) is under Type II neoplasms which are associated with more aggressive behavior