The prognostic significance of â human chorionic gonadotrophin and its metabolites in women with cervical carcinoma

Aims—To examine long term survival of women with primary and recurrent cervical carcinoma in relation to (1) excretion of â-core (a urinary metabolite of â human chorionic gonadotrophin (âhCG)) and (2) âhCG immunostaining of the tumours, to determine the suitability of these markers for assessing prognosis. Methods—This was a prospective observational study undertaken in a gynaecological oncology centre: 57 women with primary cervical cancer and 42 with recurrent disease were recruited between January 1990 and September 1992. Kaplan–Meier survival analysis with the log rank test was used to assess survival diVerences with survival rate given per year of follow up. Results—In primary disease, the four year survival for the â-core negative group was 79%, compared with 14% for the â-core positive group (p = 0.001). This was still significant for early stage disease or squamous lesions alone. In recurrent disease, â-core positivity was not prognostically significant. Immunohistochemistry was of no prognostic significance in either group. Conclusions—â-core excretion appears to be useful in assessing prognosis of primary cervical cancer but not of recurrent disease. A large prospective study of urinary â-core in early stage cervical cancer is needed to determine whether it can be used as an index for modifying treatment. (J Clin Pathol 1998;51:685–688)