Pre-operative serum level of tumour-associated trypsin inhibitor and residual tumour size as prognostic indicators in Stage III epithelial ovarian cancer.
OBJECTIVE
To evaluate the use of the pre-operative tumour-associated trypsin inhibitor (TATI) level and residual tumour size at primary surgery as a prognostic indicators for patients with Stage III epithelial ovarian cancer.


METHODS
Retrospective cohort study.


METHODS
Department of Obstetrics and Gynaecology, University Hospital, Helsinki, Finland.


METHODS
Ninety-eight women with Stage III ovarian cancer.


METHODS
TATI was measured by radioimmunoassay from serum samples obtained within one week before surgery. A cutoff value of 22 microg/L was used. Multivariate analysis included pre-operative TATI level, age, histologic grade and histologic type. Mantel-Cox test was used for calculating statistical significance of differences in survival between groups.


METHODS
Cumulative five-year survival, pre-operative serum TATI level and residual tumour size.


RESULTS
Surgery was optimal (residual tumour size < or = 2 cm) in 55 patients and suboptimal (residual tumour size > 2 cm) in 43. Pre-operative TATI level < or = 22 microg/L predicted better prognosis both in patients with optimal and suboptimal surgery compared with patients with pre-operative TATI level > 22 microg/L. Patients with optimal surgery and a pre-operative TATI > 22 microg/L had a twofold relative risk of death compared with those with a pre-operative TATI < or = 22 microg/L. The cumulative survival was less than three years for patients with suboptimal surgery and pre-operative TATI > 22 microg/L.


CONCLUSIONS
Pre-operative serum TATI in combination with residual tumour size may be useful in stratifying patients with Stage III ovarian cancer into different categories in randomised treatment trials.
Venesmaa
P
P
Department of Obstetrics and Gynaecology, University Central Hospital, Helsinki, Finland.
Stenman
U H
UH
Forss
M
M
Leminen
A
A
Lehtovirta
P
P
Vartiainen
J
J
Paavonen
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D018365:Neoplasm, Residual; D010051:Ovarian Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery; D011300:Preoperative Care; D011863:Radioimmunoassay; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D015996:Survival Rate; D014361:Trypsin Inhibitors / Q000097:blood*
D014408:Biomarkers, Tumor; D014361:Trypsin Inhibitors