PROGNOSTIC-SIGNIFICANCE OF DNA CONTENT IN EPITHELIAL OVARIAN-CANCER

The prognostic significance of cellular DNA content of epithelial ovar ian cancer as determined by flow-cytometric analysis of paraffin-embed ded tumor blocks was investigated in 87 patients. Seventy-five percent of tumors were DNA aneuploid and 25% were DNA diploid. The survival a t median follow-up for patients with DNA diploid tumors (68%) was sign ificantly longer than for DNA aneuploid tumors (49%; P = 0.003). The o ther prognostic factors which significantly affected survival were sta ge (P < 0.0001), tumor grade (P < 0.006), and residual disease at comp letion of initial surgery (P = 0.0005). When patients were separated i nto low-stage and advanced-stage disease, DNA content was a significan t prognostic variable for survival in Stage I and II patients (P = 0.0 5). In Stage III and IV patients, DNA content had no independent progn ostic significance. There were 33 patients who underwent second-look s urgery. Seven of 15 patients (47%) with negative second-look surgery w ere DNA aneuploid, whereas 17 of 18 patients (94%) with positive secon d-look surgery were DNA aneuploid. Therefore, there was a much higher likelihood of positive second-look in the DNA aneuploid group (17/24) compared to the DNA diploid group (1/9) (P = 0.003). In addition for t hose patients with negative second-look surgery, none (0/8) of the DNA diploid tumors recurred; however, 3 of 7 (43%) of the DNA aneuploid t umors recurred and died. Cox proportional/hazards analysis showed that DNA content is an independent prognostic factor for survival in epith elial ovarian cancer. Aneuploid DNA content in ovarian tumors is also correlated with more aggressive biologic behavior, and therefore, a wo rse clinical course. (C) 1994 Academic Press, Inc.