Abstract
We have evaluated the prognostic value of tumour-associated trypsin inhibitor (TATI) in stage III or IV ovarian cancer. Tumour-associated trypsin inhibitor (TATI) and CA 125 were determined in serum samples from 66 patients taken before primary surgery. TATI was elevated (> 22 micrograms l-1) in 27 patients (41%). These had a 5 year cumulative survival of 8%, whereas survival was 45% in 39 patients with normal preoperative TATI values. By contrast, the preoperative CA 125 level did not predict survival. In multivariate analysis which included age, stage, histological grade and preoperative TATI and CA 125 levels, patients with elevated preoperative TATI levels had a 2.3-fold relative risk of death (95% confidence interval 1.23-4.20; P = 0.002) compared with patients with normal preoperative levels. This result was comparable with the predictive value of primary residual tumour size, since patients with residual tumour larger than 2 cm in diameter had a 5.2-fold relative risk of death (95% confidence interval 2.55-10.68) compared with patients with a smaller or no residual tumour. Thus, preoperative determination of serum TATI may have a place in the pretreatment evaluation of patients with advanced ovarian cancer.
Highlights
CA 125 and tumour-associated trypsin inhibitor (TATI) were analysed in serum samples obtained within 1 week before surgery in all patients and 3 months after surgery in a subgroup of 25 patients
Sixty-six patients 15-86 years of age with advanced ovarian cancer and with elevated preoperative CA 125 levels were studied with approval of the local ethical committee
After surgery 61 patients received a mean of eight courses of chemotherapy with a combination of cisplatin (50 mg m-2), doxorubicin (40 mg mi-2) and cyclophosphamide (500 mg mi-2)
Summary
Sixty-six patients 15-86 (median 58) years of age with advanced (stage III or IV) ovarian cancer and with elevated preoperative CA 125 levels were studied with approval of the local ethical committee. Two patients had a mucinous cancer (Table I). After surgery 61 patients received a mean of eight courses (range 1-20) of chemotherapy with a combination of cisplatin (50 mg m-2), doxorubicin (40 mg mi-2) and cyclophosphamide (500 mg mi-2). One patient received chemotherapy with a combination of doxorubicin and cyclophosphamide. Four patients did not receive any chemotherapy. Surgery and follow-up ranging from 33 to 69 months (median 52) were performed in the same hospital
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