Serum tetranectin as a preoperative indicator for postoperative complications in Danish ovarian cancer patients.

OBJECTIVE: The association between tetranectin (TN) and selected lifestyle factors (smoking and alcohol) and the postoperative complication rate for ovarian cancer (OC) patients undergoing primary cytoreductive surgery has not yet been characterized. The aim of the study was to examine the value of TN, smoking and alcohol as indicators of postoperative complications in OC patients. METHODS: Serum TN was measured for 374 OC patients undergoing primary cytoreductive surgery. In addition, they reported their smoking and alcohol status. The prognostic value of variables was found with univariate and multivariate analyses using logistic regression analysis. RESULTS: In univariate analysis TN was the only one out of 8 variables that significantly predicted postoperative complications (OR=0.55 (95% CI: 0.34-0.87), P=0.01). High preoperative serum TN was associated with a low risk of postoperative complications. Stepwise reduction of the multivariate model demonstrated that TN and histology were the only significant co-variables (TN, OR=0.51 (95% CI: 0.32-0.83), P=0.006; histology, OR=1.70 (95% CI: 1.02-2.82), P=0.041). TN was the only indicator, which was statistical significant in both univariate and multivariate analyses. CONCLUSION: Preoperative serum TN is a significant indicator of postoperative complications in Danish OC patients and deserves to be validated in larger future studies.

Serum tetranectin is a significant prognostic marker in ovarian cancer patients.

OBJECTIVE: To evaluate the prognostic value of preoperative serum tetranectin (TN) in Danish ovarian cancer (OvCa) patients. Design. Population-based, multidisciplinary Danish case-control study of OvCa. PARTICIPANTS: A total of 445 primary OvCa patients diagnosed at one of the gynecological departments in 18 regional hospitals around Denmark during the period 1994-1999. METHODS: Serum levels of TN were evaluated preoperatively and tested for possible association with prognosis. MAIN OUTCOME MEASURES: Disease specific survival. RESULTS: During the observation period (median 45.9 months, range 0.2-121) 278 OvCa-related deaths were seen. Univariate analysis of TN and CA125 demonstrated a significant association with survival using the Cox proportional hazards model, when stratified for adjuvant treatment (TN: p < 0.0001, hazard ratio = 0.44; 95% confidence interval 0.33-0.60 and CA125: p < 0.0001, hazard ratio = 1.19; 95% confidence interval 1.11-1.27). Disease specific survival curves for patients with tumors in the early stages showed no significant association with survival, neither for TN (p = 0.68) nor for CA125 (p = 0.07). For the stage III group, a significant association with survival was found for TN (p = 0.027), but not for CA125 (p = 0.37). Multivariate Cox analysis identified TN, age, residual tumor, International Federation of Gynecology and Obstetrics stage and grade but not serum CA125 as independent prognostic variables. CONCLUSION: Preoperative serum TN is a useful prognostic indicator of advanced stage for patients with OvCa.

Prognostic value of plasma soluble urokinase plasminogen activator receptor (suPAR) in Danish patients with recurrent epithelial ovarian cancer (REOC).

The level of the soluble urokinase plasminogen activator receptor (suPAR) is elevated in tumour tissue from several types of cancer. This is the first study aiming to predict the prognosis for survival by the use of a pre-chemotherapeutic plasma suPAR value in 71 patients with recurrent epithelial ovarian cancer (REOC). For determination of suPAR, pre-chemotherapeutic blood samples from the patients with REOC were processed into plasma (EDTA) within one working day from venipuncture. The plasma suPAR level is not correlated with performance status (p=0.41), FIGO stage (p=0.09), treatment-free interval (TFI) of 12 months (p=0.26), site of recurrence (peritoneum, p=0.50 or pelvis, p=0.44), age (p=0.43), or serum CA125 (p=0.09). Univariate as well as multivariate analyses cannot demonstrate that high pre-chemotherapeutic levels of plasma suPAR (p=0.22, p=0.80) are associated with shorter survival of REOC patients. Multivariate analysis showed that only TFI of 12 months (p=0.001) and performance score status of 2 (p=0.02) were independent prognostic factors. Our study indicates that pre-chemotherapeutic measurement of plasma suPAR level in REOC patients may not be useful to identify a subgroup of patients with poor prognosis.

The prognostic value of plasma soluble urokinase plasminogen activator receptor (suPAR) levels in stage III ovarian cancer patients.

The level of the urokinase plasminogen activator receptor (uPAR) is elevated in tumor tissue from several forms of cancer. uPAR is shed from the cell surface and the soluble form, soluble urokinase plasminogen activator receptor (suPAR), has been detected in several body fluids. High plasma levels of suPAR in patients with colorectal cancer and high serum levels of suPAR in patients with recurrent metastatic breast cancer have been associated with poor prognosis. In patients with ovarian cancer (OC) it has been shown that the level of suPAR is very high in ascites and cystic fluid and that high serum levels of suPAR were associated with shorter survival of the patients. We evaluated suPAR preoperatively in plasma from primary OC stage III patients and tested for association with prognosis. The prognostic significance of suPAR was also compared to two biochemical markers; cancer antigen 125 (CA125) and tetranectin (TN). No significant differences were found between patients who died of OC compared to patients still alive regarding median plasma suPAR levels (p=0.62) and median serum CA125 levels (p=0.26). In contrast, a significant difference was found between dead and alive OC patients for the median serum TN level (p<0.0001). Dividing the patients into two groups, corresponding to preoperative plasma suPAR levels below or equal to 2.0 ng/ml and higher than 2.0 ng/ml, no significant difference in survival was found between the two groups (p=0.49). When different cut-off levels of plasma suPAR were considered (2.74 ng/ml, 3.25 ng/ml and 4.18 ng/ml), no significant differences in survival could be detected (p=0.58, p=0.68 and p=0.05). Multivariate Cox regression analysis showed that the only independent prognostic factors were radicality after primary surgery (RH=5.34; 95% CI, 2.34-12.20; p<0.0001) and preoperative serum TN (RH=0.69, 95% CI, 0.57-0.82; p<0.0001), whereas plasma suPAR (4.18 ng/ml), age, histological type of tumour and serum CA 125 had no independent prognostic value. In conclusion, preoperative plasma suPAR level was of no prognostic value in this cohort of Danish stage III OC patients.