The association with age, human tissue kallikreins 6 and 10 and hemostatic markers for survival outcome from epithelial ovarian cancer

• Published in: Archives of gynecology and obstetrics Vol. 284; no. 1; pp. 183 - 190
• Main Authors: Koh, Stephen C. L., Razvi, K., Chan, Y. H., Narasimhan, K., Ilancheran, A., Low, J. J., Choolani, M.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.07.2011; Springer Nature B.V
• Subjects: Adult; Age; Age Factors; Antigens; Biomarkers; CA-125 Antigen - blood; Cysts; Endocrinology; Female; Gynecologic Oncology; Gynecology; Hemostasis; Human Genetics; Humans; Kallikreins - blood; Kaplan-Meier Estimate; Longitudinal Studies; Medicine; Medicine & Public Health; Middle Aged; Mortality; Neoplasms, Glandular and Epithelial - blood; Neoplasms, Glandular and Epithelial - mortality; Neoplasms, Glandular and Epithelial - pathology; Obstetrics/Perinatology/Midwifery; Ovarian cancer; Ovarian Cysts - blood; Ovarian Neoplasms - blood; Ovarian Neoplasms - mortality; Ovarian Neoplasms - pathology; Ovary - pathology; Retrospective Studies; Singapore - epidemiology; Singapore; Hemostatic markers; KLK10; Age; KLK6; Ovarian cancer
• ISSN: 0932-0067; 1432-0711
• DOI: 10.1007/s00404-010-1605-z

Purpose 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%. Conclusion 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.