Introduction/Background Ovarian cancer (OC) is one of the leading causes of cancer-related death in women worldwide. The majority of OC patients will relapse following primary treatment. HE4 has been approved by the FDA in monitoring the follow-up of OC patients. Expression of the HE4 in OC depends on the histological subtype. HE4 is expressed almost in all serous and endometrioid type. In contrast, mucinous OC rarely show protein expression. The aim of this study was to compare the role of HE4 in predicting recurrence for different histologic subtypes. We also evaluate the role of HE4 in predicting relapse after second-line of treatment.

Methodology We retrospectively analysed 188 patients with OC (10% FIGO I, 4%- II, 81%- III, 5%- IV) treated between November 2005 and September 2017. The patients were followed up during the first and second line treatment using tumour marker (CA 125, HE4) together with rectovaginal examination, or CT if necessary.

Results We identified 188 patients with OC. Of 188 patients evaluated, 160 had serous, 10 endometrioid, 9 mucinous and 9 clear cell carcinoma. We evaluated median PFS in all histopatological subtypes. Patients were divided into groups: group A: HE4 (<70pmol/l) after first line treatment and group B: HE4 (>70 pmol/l). The median PFS for mucinous histotyp for group A and B was 28,7 and 34 months respectively and for clear cell carcinoma was 30 and 16 months respectively. 25% of patients with serous OC without normalization of HE4 after I line treatment developed reccurency within the first year of follow-up. CA125 and HE4 value after the first line treatment, and during follow-up were found statistically significant and included into a multivariate logistic regression model to determine the risk of recurrency.

Conclusion Our study showed that HE4 marker is a useful tool for early detection of recurrency excluding mucinous type OC.

Disclosure Nothing to disclose