High preoperative serum sVCAM-1 concentration as a predictor of early ovarian cancer recurrence

Background: Role of soluble vascular cell adhesion molecule-1 (sVCAM-1) in ovarian cancer is largely unclear. It was shown that mesothelial expression mediates tumour cell invasion and is associated with metastases in advanced ovarian cancer. Material and methods: In our prospective study we measured preoperative serum sVCAM-1 in 37 patients with advanced ovarian cancer and evaluated correlation with disease recurrence. Serum samples were obtained prior to surgery, ascites was collected during the surgery and all analysed by flow cytometric bead-based assay. ROC analysis was used to identify a cut-off value for sVCAM-1. Survival curves were calculated using Kaplan-Meier method. The association between sVCAM-1 and survival was investigated with Cox regression models, adjusting for age at surgery. A p of Results: Mean sVCAM-1 serum concentration in all patients before operation was 1564.68 ± 435.65 ng/ml while mean ascites level was 801.84 ±244.35 ng/ml. Follow up period was minimum 27 and the maximum 58 months. Patients were divided in two groups according to time to recurrence. Group A: 20 patients with disease progress or relapse within 12 months (mean serum level 1660.54±417.93 ng/ml; mean ascites level 827.92±290.36) and group B: 17 patients with tumour relapse after more than 12 months (mean serum level 451.91±441.15ng/ml; mean ascites level 771.16±179.93). There was a correlation between serum and ascites concentrations in group A and not in the patients from group B. The statistically significant difference was observed in serum concentration but not in ascites concentrations of sVCAM-1, There were no differences in grade, histology and stage of the tumour between the groups. sVCAM-1 and age resulted correlated (Spearman r=0.32, p=0.048). In Cox regression models after adjusting for age at surgery, sVCAM-1 above 1,400 ng/ml was associated with impaired DFS (hazard ratio 3.824; 95% confidence interval 1.460 to 9.374; p=0.003) and impaired OS (hazard ratio 13.394; 95% confidence interval 1.693 to 105.3985; p=0.014. Conclusions: This is the first study demonstrating that higher serum sVCAM-1 concentrations at the time of diagnosis might be predictive for early relapse. Serum sVCAM-1 can be potential marker for ovarian cancer follow-up.