Prognostic factors in extraovarian primary peritoneal carcinoma

Objective. To determine the pathological, clinical, and therapeutic factors which had prognostic significance in women with extraovarian primary perit oneal carcinoma (EOPPC). Methods. A retrospective, clinicopathologic study was conducted of 75 women diagnosed with EOPPC. Diagnosis and assessment of prognostic pathological factors were based on the Gynecologic Oncology Group (GOG) criteria. Univar iate and multivariate analyses were used to assess the following factors fo r their effect on overall survival: age, parity, presenting symptoms and si gns, ascites, CA 125 level, history of oophorectomy, maximum ovarian dimens ion, histologic type, architectural and nuclear grades, number of mitosis a nd psammoma bodies, depth of ovarian invasion, estrogen and progesterone re ceptors (positive, negative), p53 overexpression (present, absent), perform ance status (GOG criteria), stage (FIGO criteria for ovarian cancer), debul king surgery (optimal versus suboptimal), first-line chemotherapy (platin-b ased without paclitaxel versus platin/paclitaxel), secondary cytoreduction, and second-line chemotherapy (paclitaxel-based versus no paclitaxel). Results. The median overall survival of all patients was 23.5 months (95% C I 18.6, 39.8 months). The 5-year survival was 26.5% (SE 6.7%). p53 overexpr ession and estrogen and progesterone receptor positivity were demonstrated in 42.4, 50.0, and 6.3%, respectively. In univariate analysis, performance status, primary debulking surgery, stage, and age were significant on overa ll survival (P < 0.001, <0.001, 0.004, and 0.012, respectively). In multiva riate analysis, only performance status (P < 0.001) and primary debulking s urgery (P = 0.03) were independent prognostic factors. Conclusions. Overall survival in women with EOPPC is affected significantly by performance status and primary debulking surgery as independent variabl es. To improve survival, efforts should be made to achieve optimal tumor cy toreduction at primary surgery. (C) 1998 Academic Press.