THE PROGNOSTIC IMPLICATION OF ASCITES IN ADVANCED-STAGE OVARIAN-CANCER

Ovarian carcinoma accounts for greater than 50% of the gynecologic can cer deaths in the United States each year. One of the central reasons for this dismal outcome is that many patients present with advanced di sease. In this series, a retrospective review of 130 patients with sta ge III and IV invasive epithelial ovarian carcinoma was performed to d etermine the prognostic significance of ascites. Patients were divided into two study groups based upon the presence or absence of ascites. Survival for the entire study group was 15%, but differed markedly whe n separated for the presence of ascites. In these patients, ascites wa s associated with a statistically decreased 5-year survival of 5% vers us 45% without ascites (P = 0.0001). Individuals were found to be simi lar in each group when examined for age, height, weight, cell type, gr ade, and surgical and chemotherapeutic treatment modalities. More pati ents proportionately with stage IIIC disease had ascites than those wi thout ascites (P = 0.0015). More of the individuals without ascites un derwent second-look laparotomies and achieved a negative result than t hose with ascites (P = 0.04; P = 0.0038). We conclude that ascites in the presence of stage III and IV disease produces an almost uniformly fatal outcome. (C) 1996 Academic Press, Inc.