TUMOR DNA-PLOIDY AND PROGNOSIS OF PATIENTS WITH SEROUS CYSTADENOCARCINOMA OF THE OVARY

Background. Although it is important to determine any relationship bet ween tumor DNA ploidy and its biologic behavior, the correlation betwe en DNA ploidy and the prognosis of patients with ovarian cancer is not conclusive. Accordingly, the authors evaluated the clinical applicati on of DNA ploidy in ovarian cancer. Methods. Flow cytometric measureme nts were performed in 45 selected patients with well-differentiated se rous cystadenocarcinoma of the ovary, Stages Ic-IV. All of them had th e same surgical procedure, with retroperitoneal lymphadenectomy includ ing paraaortic nodes, followed by the same postoperative chemotherapeu tic regimen. Results. Of the 45 ovarian cancers, 28 were diploid and 1 7 were aneuploid. The 2-year survival rate and the estimated 5-year su rvival rate for patients with diploid tumors were significantly greate r than those for patients with aneuploid tumors (73.2% versus 46.7% an d 29.1% versus 22.4%, respectively). The 2-year survival rate in patie nts with advanced disease (Stage III or IV) was also significantly hig her for those with diploid tumors (53.3% versus 37.4%, respectively), but the estimated 5-year survival rate was similar in both groups (8.9 % versus 9.1%, respectively). Patients with advanced disease had aneup loid tumors more frequently than those with early-stage disease. A sig nificantly higher incidence of retroperitoneal lymph node metastasis w as observed in aneuploid tumors than in diploid tumors (43.8% in diplo id tumors versus 86.7% in aneuploid tumors). The authors found no diff erence in the response to chemotherapy between diploid and aneuploid t umors. Conclusions. Although tumor DNA ploidy was not as reliable as c onventional parameters such as surgical stage in establishing prognosi s, it may provide an indicator of lymph node involvement.