title: Pre-operative serum level of tumour-associated trypsin inhibitor and residual tumour size as prognostic indicators in Stage III epithelial ovarian cancer.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynaecology, University Central Hospital, Helsinki, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Venesmaa
authors.forename: U H
authors.initials: UH
authors.lastname: Stenman
authors.forename: M
authors.initials: M
authors.lastname: Forss
authors.forename: A
authors.initials: A
authors.lastname: Leminen
authors.forename: P
authors.initials: P
authors.lastname: Lehtovirta
authors.forename: J
authors.initials: J
authors.lastname: Vartiainen
authors.forename: J
authors.initials: J
authors.lastname: Paavonen
mesh_terms: 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*
chemical_list: D014408:Biomarkers, Tumor; D014361:Trypsin Inhibitors