Random urinary cyclic 3',5' guanosine monophosphate in epithelial ovarian cancer: relation to other prognostic variables and to survival.

Random urinary cyclic guanosine monophosphate (cyclic GMP) has been measured in a control group of 83 women and in 92 women with histologically proven epithelial ovarian cancer. Forty-eight cancer patients (53%) had levels greater than the mean +2SD of the control population. There was no correlation between urinary cyclic GMP and tumour histology, degree of differentiation or stage. Patients with gross residual disease after laparotomy had higher postoperative levels. This degree of sensitivity in addition to poor specificity for ovarian cancer renders this marker unsuitable for screening purposes. While residual disease state after surgery was found to be the best single predictor of survival, an elevated urinary cyclic GMP level before chemotherapy was found to be an independent adverse prognostic variable.