SERUM CONCENTRATIONS OF CANCER ANTIGEN-125, PLACENTAL ALKALINE-PHOSPHATASE, CANCER-ASSOCIATED SERUM ANTIGEN AND FREE BETA-HUMAN CHORIONIC-GONADOTROPIN AS PROGNOSTIC MARKERS FOR EPITHELIAL OVARIAN-CANCER

Objective To investigate the prognostic significance of elevated level s of cancer antigen 125 (CA125), placental alkaline phosphatase (PLAP) , free beta human chorionic gonadotrophin (hCG) and cancer-associated serum antigen (CASA) in women with primary epithelial ovarian carcinom a. Design A two year follow up study of survival. Setting A tertiary c are gynaecological oncology unit. Participants One hundred and eleven women with histologically confirmed epithelial ovarian cancer. Main ou tcome measures Survival over a two year period. Results Stage correcte d log-rank chi(2) tests demonstrated a significant effect on survival for all four tumour markers (CA125 P = 0.0142; PLAP P < 0.0001; CASA P = 0.0098; hCG P = 0.0002). This was confirmed when each variable was fitted together with disease stage in Cox proportional hazard models. When fitted as multiple variables in a Cox proportional hazard model, the addition of free beta-hCG and CASA to disease stage, PLAP concentr ations and CA125 levels did not demonstrate further prognostic value. Conclusions Levels of all four markers correlate with survival in pati ents with epithelial ovarian cancer. The combination of PLAP and CA125 concentrations together with disease stage may be used to predict sur vival but the addition of hCG and CASA levels do not give additional p rognostic information.