QUANTITATIVE PATHOLOGICAL VARIABLES AS PROGNOSTIC FACTORS FOR OVERALLSURVIVAL IN DANISH PATIENTS WITH FIGO STAGE-III OVARIAN-CANCER

Earlier studies have shown the strong prognostic value of the mitotic activity index (MAI), volume percent of epithelium (VPE), mean nuclear area (MNA) and the standard deviation of the nuclear area (SDNA) in e arly and advanced ovarian cancer. In one study of Danish patients howe ver, these features were not significant and methodological causes wer e excluded as a cause of this. Therefore, we have re-evaluated these f eatures in another group of 112 Danish patients with FIGO stage III ov arian cancer who were treated with debulking surgery followed by cispl atin combination chemotherapy. Thirty-seven patients (33%) survived. I n survival analysis residual disease status, performance status, perit oneal carcinomatosis, histologic grade, age and the presence or absenc e of ascites had significant influence on the eventual clinical outcom e. Of the quantitative pathologic features the MAI, MNA, SDNA were cor related with grade, but had stronger prognostic value than grade. Resi dual disease status, performance status at diagnosis, peritoneal carci nomatosis, the MNA and the SDNA were the best single prognostic variab les (P < 0.00001). With multivariate analysis residual disease status, MNA and age had independent additional value (grade was not selected once these more significant features were included). With this combina tion (called F3MS) four prognostically important groups could be disti nguished (MC = 61.7, P < 0.00001). Survival in the most favourable F3M S group (n = 28) was 71% (median survival time 84 months), while in th e worst group (n = 29) none of the patients survived and the median su rvival time in this group was only 13 months (Relative Risks (RR) = 3. 50). It is concluded that morphometric variables have important value in predicting prognosis in patients with FIGO stage III ovarian cancer and add to the classical prognostic factors of residual disease statu s and age.