The relationship of clinical and laboratory parameters and survival in ovarian cancer

Introduction: Ovarian cancer is the second most common cancer among gynecological cancers and also the most common cause of death. The prognosis of ovarian cancer is closely related to the stage of the disease. There are not enough studies in the literature showing the relationship between clinical and laboratory parameters and survival in ovarian cancer. Therefore, in our study, we aimed to investigate the relationship between the stages of ovarian cancer at the time of diagnosis, metastasis sites, parity and gravity numbers, menopause ages, treatments applied, laboratory parameters (CA-125, CEA, CRP, albumin, creatine) and overall survival (OS) and progression-free survival (PFS). Method: In this study, 83 patients who applied to Gaziantep University Medical Oncology Department between 11.04.2012 and 18.12.2020 and were treated for ovarian cancer were evaluated retrospectively. We compared OS and PFS of the patients with demographic data, laboratory parameters, stages at the time of diagnosis, and metastasis sites. Results: The patients'median age was 57 (min-max: 18-85) at the time of diagnosis. The median age of menopause of 70 patients who were in the menopause period was 48 (min-max: 18-57). Ascites was detected in 63 patients at the time of diagnosis. The most common histopathological subtype was HGSC (High grade serous carcinoma) (65 patients), while the least detected subtype was Brenner's tumor. 41% (34 patients) of all patients had Stage IIIC disease at the time of diagnosis. Metastatic lesions were present at the time of diagnosis in 72.3% (60 patients) of the patients. The most common site of metastasis was the colon and small intestine with 37.3% (31 patients). WT1 staining was present in 26.5% (22 patients) of the patients. The rate of staining with estrogen was 34.9% (29 patients), and the rate of staining with progesterone was 30.1% (25 patients). The mean OS of the patients was 36.85±24.18 months and the median OS of 31.5 (1.4-91.8) months. According to the data we obtained, the median survival rate was 93% for 12 months, 81.6% for 24 months, 69.9% for 36 months and 43.9% for 60 months. In our study, a statistically significant correlation was found between CA-125 and WT1 staining characteristics at the time of diagnosis and GS. The OS duration of the patients was found to be higher in those with low CA125 values at the time of diagnosis (p=0.011). Likewise, the OS duration of the patients whose tumors did not show staining with WT1 was significantly higher (p=0.036). The mean PFS time of the patients was 19.12 ± 16.33 months, and the median PFS time was 13 (12 -91.8) months. In our study, a statistically significant correlation was found between WT1 staining and PFS (p=0.040). The PFS of the patients whose tumor was stained with WT1 was found to be significantly higher. Conclusion: Considering the results of our study, it is seen that ascites in the abdomen is a very common finding in the postmenopausal period in ovarian cancer. Especially in early postmenopausal women, ovarian cancer should be kept in mind as a differential diagnosis in newly developing ascites. In addition, according to the results of our study, it is seen that the first system to be evaluated in terms of metastasis in patients with ovarian cancer is the gastrointestinal system. WT1 and CA125 level at the time of diagnosis are thought to be important markers in demonstrating overall survival. It seems that a single parameter will not be sufficient to predict PFS. It is thought that PFS estimation studies can yield more accurate results with models to be developed by using multiple parameters together. Keywords: Overall survival; Progression-free survival; WT-1; Estrogen; Progesterone; Ovarian cancer