Introduction/Background In this study we aim to analyse the impact of five biomarkers on overall survival (OS) in FIGO stage III-IV ovarian-, fallopian tube-, peritoneal- and abdominal cancer, together designated OC, in a cohort of women.
Methodology All 428 women with FIGO stage III-IV OC who were diagnosed with serous adenocarcinoma (high grade or grade not stated), endometrioid adenocarcinoma or clear-cell carcinoma in the South East Health Region in Sweden in the period January 2008 to November 2017 were included. Only the women who had undergone primary debulking surgery (PDS) or neoadjuvant chemotherapy (NACT) were included. Pre-treatment laboratory, demographic and clinical data were retrospectively retrieved from the patients‘ charts. The median value for each of the biomarkers (haemoglobin, thrombocytes, albumin, C-reactive protein (CRP) and CA-125) was calculated and the women were dichotomized as having above or below the median. OS was estimated using the Kaplan-Meier method. Comparison of groups was carried out using the Cox Proportional Hazards Regression Analysis. Adjustment was done for age, calendar year of treatment, body mass index and primary treatment modality (PDS/NACT followed by delayed PDS/NACT only).
Results The women had significantly shorter OS if the albumin level was under the median, or the thrombocytes, CRP or CA-125 levels were over the median. Women with the levels of all three biomarkers thrombocytes, albumin and CRP in adverse direction had significantly shorter OS than the women who had the level of at least one of these biomarkers in the favourable direction.
Conclusion The levels of thrombocytes, albumin, CRP and CA-125 as well as the combination of thrombocytes, albumin and CRP were independent predictors of OS in FIGO stage III–IV OC even when adjusted for treatment modality. This might imply that biologic factors are the most important determinant for OS in OC.
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