Plasma steroid hormones in women with epithelial ovarian carcinoma

Plasma concentrations of steroid hormones were investigated in 51 postmenopausal or bilaterally oophorectomized women with epithelial ovarian carcinoma, but free from other malignant or endocrine disease. All FIGO stages and the histological types IC, IIC, IIIC and V are represented. Plasma levels of progesterone (P), 20 alpha-hydroxyprogesterone (20 alpha-OH-P), androstenedione (A), testosterone (T), estradiol (E2), Sex-Hormone-Binding Globulin (SHBG) and albumin were analysed, and unbound fractions of testosterone (UT) and estradiol (UE) were calculated. Blood samples were drawn for radio-immunoassay prior to and during chemotherapy at monthly intervals on four occasions. Thus, it was possible to study how plasma levels of steroid hormones are influenced by tumor volume, stage, histological type, effect of chemotherapy, recurrence of disease, and finally, whether determination of the initial plasma level of any steroid hormone, separately or in combination, may give an indication as to the prognosis of the disease. Plasma hormone levels were also compared with those of a control group of postmenopausal women (PM), a control group of fertile women in early follicular phase of the menstrual cycle (FPh), and, finally, with a control group of postmenopausal women with a non-gynecologic disseminated malignant disease (DMD). A relationship has been found between tumor volume and plasma concentration of the investigated hormones. Corresponding relationships have also been found vis-à-vis FIGO stage and histological type, though probably secondary to tumor volume. With reduction of tumor volume during treatment, a concomitant decrease in plasma concentration has been found concerning P, A and E2. The unbound fraction of T was not influenced by therapy and did not differ from PM controls. With the combined determination of P and A it has been possible to detect recurrence of disease earlier than by clinical means in the majority of cases. Certain combinations of the initial values of P, A, T and A/alb seem to predict prognosis as well as or better than does FIGO stage. In conclusion, a correlation between steroidogenesis and progress of epithelial ovarian carcinoma seems to exist. Steroidogenesis might also reflect the prognosis of the disease.