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Consecutive inclusion of 198 patients diagnosed with EOC was conducted. Blood samples were collected prior to surgery and tissue samples during surgery. Patient data were registered prospectively in the Danish Gynecologic Cancer Database. The association between serum <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content>4 and <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content>4 tissue protein expression, resistance to adjuvant chemotherapy, PFS, and overall survival were analyzed in univariate analyses and in multivariate analyses adjusted for age, performance score, surgical outcome, stage, grade, and histological subtype. Serum <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content>4 levels predicted chemotherapy resistance, PFS, and overall survival correlated significantly (p &lt; 0.001) in the univariate analyses; but after adjustment in a multivariate model, serum <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content>4 was insignificant, except in a subgroup analysis of postmenopausal women, where serum <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content>4 significantly predicted resistance to chemotherapy and progression\u2010free survival. <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content>4 tissue protein expression predicted PFS (p = 0.022) and overall survival (p = 0.047) in the univariate analysis, while <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content>4 tissue protein expression failed to predict these outcomes in the adjusted multivariate analyses. Serum <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content>4 or <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content>4 tissue protein expression are not independent factors of chemotherapy resistance or survival in patients with <jats:styled-content style=\"fixed-case\">EOC<\/jats:styled-content>, but serum <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content>4 might predict chemotherapy resistance and PFS in postmenopausal women.<\/jats:p>","DOI":"10.1111\/apm.12625","type":"journal-article","created":{"date-parts":[[2016,11,16]],"date-time":"2016-11-16T19:32:53Z","timestamp":1479324773000},"page":"1038-1045","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["HE4 as a predictor of adjuvant chemotherapy resistance and survival in patients with epithelial ovarian cancer"],"prefix":"10.1111","volume":"124","author":[{"given":"Mona","family":"Aarenstrup Karlsen","sequence":"first","affiliation":[{"name":"Molecular Unit Department of Pathology Herlev and Gentofte Hospital University of Copenhagen Herlev Denmark"},{"name":"Department of Gynecology Rigshospitalet University of Copenhagen Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claus","family":"H\u00f8gdall","sequence":"additional","affiliation":[{"name":"Department of Gynecology Rigshospitalet University of Copenhagen Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lotte","family":"Nedergaard","sequence":"additional","affiliation":[{"name":"Department of Pathology Rigshospitalet University of Copenhagen Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kira","family":"Philipsen Prahm","sequence":"additional","affiliation":[{"name":"Molecular Unit Department of Pathology Herlev and Gentofte Hospital University of Copenhagen Herlev Denmark"},{"name":"Department of Gynecology Rigshospitalet University of Copenhagen Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikoline Marie","family":"Schou Karlsen","sequence":"additional","affiliation":[{"name":"Molecular Unit Department of Pathology Herlev and Gentofte Hospital University of Copenhagen Herlev Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Weng Ekmann\u2010Gade","sequence":"additional","affiliation":[{"name":"Department of Gynecology Rigshospitalet University of Copenhagen Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tine","family":"Henrichsen Schnack","sequence":"additional","affiliation":[{"name":"Department of Gynecology Rigshospitalet University of Copenhagen Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Svenstrup Poulsen","sequence":"additional","affiliation":[{"name":"Molecular Unit Department of Pathology Herlev and Gentofte Hospital University of Copenhagen Herlev Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ib","family":"Jarle Christensen","sequence":"additional","affiliation":[{"name":"Molecular Unit Department of Pathology Herlev and Gentofte Hospital University of Copenhagen Herlev Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Estrid","family":"H\u00f8gdall","sequence":"additional","affiliation":[{"name":"Molecular Unit Department of Pathology Herlev and Gentofte Hospital University of Copenhagen Herlev Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,11,16]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2015.07.022"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21332"},{"key":"e_1_2_6_4_1","unstructured":"Annual Report 2014\u20102015.Danish Gynecological Cancer Database. 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