P. Venesmaa et al., PREOPERATIVE SERUM LEVEL OF TUMOR-ASSOCIATED TRYPSIN-INHIBITOR AND RESIDUAL TUMOR SIZE AS PROGNOSTIC INDICATORS IN STAGE-III EPITHELIAL OVARIAN-CANCER, British journal of obstetrics and gynaecology, 105(5), 1998, pp. 508-511
Objective To evaluate the use of the pre-operative tumour-associated t
rypsin inhibitor (TATI) level and residual tumour size at primary surg
ery 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 wit
hin one week before surgery. A cutoff value of 22 mu g/L was used. Mul
tivariate analysis included pre-operative TATI level, age, histologic
grade an;l histologic type. Mantel-Cox test was used for calculating s
tatistical significance of differences in survival between groups. Mai
n outcome measures Cumulative five-year survival, pre-operative serum
TATI level and residual tumour size. Results Surgery was optimal (resi
dual tumour size less than or equal to 2 cm) in 55 patients and subopt
imal (residual tumour size > 2 cm) in 43. Pre-operative TATI level les
s than or equal to 22 mu g/L predicted better prognosis both in patien
ts with optimal and suboptimal surgery compared with patients with pre
-operative TATI level > 22 mu L. Patients with optimal surgery and a p
re-operative TATI > 22 mu g/L had a twofold relative risk of death com
pared with those with a pre-operative TATI less than or equal to 32 mu
g/L. The cumulative survival was less than three years for patients w
ith suboptimal surgery and pre-operative TATI > 22 mu g/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.