According to a recent article published in the Journal of Clinical Oncology, levels of the protein tissue factor (TF) prior to surgery may help to predict patient prognosis in ovarian cancer. Ultimately, more accurate understanding of a patient’s prognosis may help guide individualized treatment options.
Ovarian cancer is the fourth leading cause of cancer death among women in the U.S.; according to the American Cancer Society, an estimated 22,220 new cases were diagnosed in 2005.
Unfortunately, once ovarian cancer spreads from its site of origin, long-term survival rates remain very low. In response, researchers continue to evaluate ways to detect and treat the disease in early stages. The goal of early detection and treatment is to improve survival for these patients. Researchers are also evaluating ways to individualize treatment options so that patients who are at a greater risk of developing a recurrence can benefit from additional therapy, while those with a lesser risk can be spared from the side effects associated with more therapy.
Researchers from the MD Anderson Cancer Center and the University of Iowa recently conducted a clinical study to evaluate the potential of using levels of TF in a patient’s blood prior to surgery as an indicator of outcomes among women with ovarian cancer.
TF is involved in clotting of the blood and is also thought to play a role in new growth of blood vessels that help feed cancer cells. The researchers also evaluated whether the TF levels could help distinguish between ovarian cancer and non-cancerous conditions.
The study included 98 patients with ovarian cancer, 30 patients with low malignant potential tumors (LMP-a precancerous tumor on the ovary that may ultimately become cancer; this disease rarely spreads beyond the ovary); 16 patients with benign tumors (non-cancerous); and 39 patients with adnexal masses (normal, self-limiting small masses found on the ovaries that are typically present in menstruating women).
- TF levels were significantly higher among women with ovarian cancer (median 85.2 pg/mL) than those with LMP (median 12.8 pg.mL) or benign tumors (median 30.7 pg/mL).
- Patients with a TF level of above 190 pg/mL-a high level-had a 3.4-fold increased risk of death from ovarian cancer than their counterparts with a lower TF level.
- Median survival for patients with high TF levels was only 1.64 years, compared to a median survival of 5.13 years for those with low TF levels.
The researchers concluded that pre-operative levels of TF may help distinguish between ovarian cancer and benign diseases of the ovary. It may also help determine the prognosis of patients with ovarian cancer. Future study is necessary to confirm these findings and to compare TF levels to other potential markers.
Patients at a high risk of developing ovarian cancer may wish to speak with their physician regarding their individual risks and benefits of participating in a clinical trial further evaluating screening or prognostic markers for their disease.
Reference: Han L, Landen C, Kamat A, et al. Preoperative Serum Tissue Factor Levels Are an Independent Prognostic Factor in Patients with Ovarian Carcinoma. Journal of Clinical Oncology. 2006; 24: 755-761.