PROGNOSTIC-SIGNIFICANCE OF DNA CONTENT AND S-PHASE FRACTION IN EPITHELIAL OVARIAN CARCINOMAS ANALYZED BY IMAGE CYTOMETRY

The objective of this study was to evaluate the prognostic significanc e of DNA ploidy and S-phase fraction (SPF) in epithelial ovarian carci nomas analyzed by image cytometry. Frozen tissue of 103 epithelial ova rian carcinomas was analyzed for DNA ploidy and SPF with a Cell Analys is System Image Analyser (CAS 200, Becton-Dickinson) and correlations with clinical and histomorphologic factors and time to progression and overall survival were evaluated by univariate and multivariable analy sis. Fifty;four percent of the ovarian carcinomas were found to be dip loid, 38% aneuploid, and 8% tetraploid. The S-phase fraction was low ( <5%) in 27%, intermediate (5-14.5%) in 47%, and high (greater than or equal to 14.5%) in 26% of the patients. By univariate analysis overall survival and time to progression were significantly correlated with t he S-phase fraction (P = 0.003 and P = 0.003), but not with DNA ploidy (P;= 0.31 and P = 0.51). A DNA index > 1.4 was correlated with poor o utcome but the result did not achieve formal statistical significance (P = 0.08 and P = 0.12). A high SPF was a strong predictor of early re currence, while a low SPF identified patients with a favorable long-te rm outcome. Other significant predictors off survival were FIGO stage, grade of differentiation, presence of distant metastasis, residual tu mor, lymph node metastasis, and patient age. In multivariable statisti cal analysis only FIGO stage, histologic grade, and residual tumor aft er surgery were independent predictors of overall survival and time to progression. (C) 1998 Academic Press.