Serum albumin and CA125 are powerful predictors of survival in epithelial ovarian cancer

Objective To assess the prognostic significance of presentation serum albumin, clinical stage and CA125 levels in ovarian cancer. Design Retrospective analysis of data using a Cox proportional hazards model. Setting A district general hospital oncology unit. Subject One hundred and fourteen consecutive patients with epithelial ovarian cancer. Interventions Cytotoxic chemotherapy and surgery. Main outcome measure Survival. Results A linear increase in risk was observed with high log CA125 (P < 0.0001) and with low albumin (P < 0.0001). In late stage patients (III and IV) albumin is the best predictor of survival (P= 0.0006). The presence of ascites, blood transfusion, type of surgery or chemotherapy did not improve the predictive model. Conclusions CA125 and albumin can be used to identify prognostic subgroups independently of stage. Albumin alone can also be used as a predictor of survival. A simple classification of patients into three groups based on serum albumin of 41 g/l or more, 35 to 40 g/l and 34 g/l or less provides a clear separation of survival curves in the present group of patients.