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.
Subjects: 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.