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Pre‐operative serum level of tumour‐associated trypsin inhibitor and residual turnour size as prognostic indicators in Stage III epithelial ovarian cancer
Author(s) -
Venesmaa Pekka,
Stenman UlfHåkan,
Forss Matti,
Leminen Arto,
Lehtovirta Pentti,
Vartiainen Juhani,
Paavonen Jorma
Publication year - 1998
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1998.tb10150.x
Subject(s) - medicine , ovarian cancer , stage (stratigraphy) , gastroenterology , statistical significance , cancer , retrospective cohort study , surgery , oncology , gynecology , biology , paleontology
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. Design Retrospective cohort study. Setting Department of Obstetrics and Gynaecology, University Hospital, Helsinki, Finland. Participants 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 μg/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. Main outcome measures Cumulative five‐year survival, pre‐operative serum TATI level and residual tumour size. Results Surgery was optimal (residual tumour size ≤ 2 cm) in 55 patients and suboptimal (residual tumour size > 2 cm) in 43. Pre‐operative TATI level ≤ 22 μg/L predicted better prognosis both in patients with optimal and suboptimal surgery compared with patients with pre‐operative TATI level > 22 μ/L. Patients with optimal surgery and a pre‐operative TATI > 22 μg/L had a twofold relative risk of death compared with those with a pre‐operative TATI ≤ 22 μg/L. The cumulative survival was less than three years for patients with suboptimal surgery and pre‐operative TATI > 22 μg/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.