Objective To evaluate the use of the pre-operative tumour-associated trypsin inhibitor (TATI) level and residual tumour size at primary surgery as a prognostic indicators for patients with Stage 111 epithelial ovarian cancer.Design Retrospective cohort study. Main outcome measures Cumulative five-year survival, pre-operative serum TATI level and residual tumour size.Results Surgery was optimal (residual tumour size I 2 cm) in 55 patients and suboptimal (residual tumour size > 2 cm) in 43. Pre-operative TATI level I 22 pg/L predicted better prognosis both in patients with optimal and suboptimal surgery compared with patients with pre-operative TATI level > 22 p a . Patients with optimal surgery and a pre-operative TATI > 22 pg/L had a twofold relative risk of death compared with those with a pre-operative TATI I 22 pg/L. The cumulative survival was less than three years for patients with suboptimal surgery and pre-operative TATI > 22 pg/L.Conclusions Pre-operative serum TATI in combination with residual tumour size may be useful in stratifying patients with Stage I11 ovarian cancer into different categories in randomised treatment trials.

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Summary We have evaluated the prognostic value of tumour-associated trypsin inhibitor (TATI)

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