title: The association with age, human tissue kallikreins 6 and 10 and hemostatic markers for survival outcome from epithelial ovarian cancer.
abstract: OBJECTIVE
  To assess known cancer biomarkers CA-125, human tissue kallikreins KLK6 and KLK10, hemostatic markers and age with 5-year survival outcome from epithelial ovarian cancer.
  
  
  METHODS
  Forty-one benign cyst cohorts and 83 patients diagnosed with ovarian cancer were recruited. The following assays were performed: fibrinogen, vWF antigen, D: -dimer, ATIII activity, tPA, PAI-1, uPAR, KLK6, KLK10 and CA-125. Follow-up visits of cancer patients of more than 60 months were noted. Data between those who survived past 60 months and mortality from cancer were analyzed.
  
  
  RESULTS
  Only 24 patients lived past 60 months, and 31 died (advanced stage n = 27). Those living past 60 months were significantly older and associated with similar pre-operative levels seen in benign cyst cohorts especially for KLK6, fibrinogen, vWF, AT levels despite upregulation of D: -dimer, CA-125 and KLK10. Ovarian cancer cohorts living past 60 months were younger than those who died within 12 months (n = 12). Mortality within 12 months was associated with older age, upregulation of KLK6, fibrinogen, D: -dimer, vWF, tPA antigen and reduced ATIII levels. Similarly, mortality within 36 months of disease showed older age with upregulation of CA-125, KLK6 D: -dimer vWF antigen and tPA antigen levels. Late stage cancer (III/IV) showed upregulated CA-125, KLK6, KLK10, D: -dimer and reduced AT compared to early stage cancer (I/II). The 5-year survival rate for early cancer was 80%, advanced 22.9% and overall 5-year survival rate was 43.6%.
  
  
  CONCLUSIONS
  Older age together with the novel biomarkers studied and their association with adverse outcome from epithelial ovarian cancer was seen especially within 12 and 36 months of disease. Those who lived past 60 months of disease showed similar pre-operative levels seen in benign cyst cohorts despite elevated D: -dimer, CA125 and KLK 10. An enlarged study is needed to confirm these findings.
authors.affiliation: Department of Obstetrics and Gynaecology, National University Health Systems (NUHS), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore. Stephen_KOH@NUHS.edu.sg
authors.forename: Stephen C L
authors.initials: SC
authors.lastname: Koh
authors.forename: K
authors.initials: K
authors.lastname: Razvi
authors.forename: Y H
authors.initials: YH
authors.lastname: Chan
authors.forename: K
authors.initials: K
authors.lastname: Narasimhan
authors.forename: A
authors.initials: A
authors.lastname: Ilancheran
authors.forename: J J
authors.initials: JJ
authors.lastname: Low
authors.forename: M
authors.initials: M
authors.lastname: Choolani
mesh_terms: D000328:Adult; D000367:Age Factors; D018394:CA-125 Antigen / Q000097:blood*; D005260:Female; D006487:Hemostasis; D006801:Humans; D007610:Kallikreins / Q000097:blood*; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000097:blood / Q000401:mortality* / Q000473:pathology; D010048:Ovarian Cysts / Q000097:blood; D010051:Ovarian Neoplasms / Q000097:blood / Q000401:mortality* / Q000473:pathology; D010053:Ovary / Q000473:pathology; D012189:Retrospective Studies; D012846:Singapore / Q000453:epidemiology
chemical_list: D018394:CA-125 Antigen; C100936:KLK10 protein, human; C103551:KLK6 protein, human; D007610:Kallikreins