Prognostic value of DNA quantification in early epithelial ovarian carcinoma

Objective: To evaluate the prognostic value of flow cytometric DNA quantifi cation and immunohistochemical expression of c-erbB-2 and p53, and traditio nal clinicopathologic variables in stages I-II invasive epithelial ovarian cancer. Methods: We retrospectively reviewed 77 cases of stages I-II ovarian cancer after comprehensive surgical staging. We recorded anthropometric data (age , menopausal status, weight loss, Karnofsky index) and pathologic variables (tumor size, bilaterality, capsular status, ascites, peritoneal cytology, histologic type, and grade). In 72 cases representative paraffin-embedded s amples were available for DNA quantification and immunohistochemical evalua tion of c-erbB-2 and p53 overexpression. Most women (87%) had received cisp latin-based adjuvant chemotherapy. Results: The median follow-up was 90 months (range 50-148 months). The ti-y ear overall disease-free survival rate was 70% (95% confidence interval [CI ] 60%, 81%), and overall global survival was 77% (95% CI 67%, 87%). Multiva riable analysis using Cox stepwise regression identified DNA content (odds ratio [OR] 12.3; P <.001) and stage (OR 1.4, P = .09) as independent poor p rognosis factors for relapse, and DNA content (OR 9.8, P <.001) as the main independent factor for survival. In stepwise discriminant analysis the com bination of DNA content and stage provided a correct prediction of relapse in 78% of women. Conclusion: Flow cytometric DNA quantification was the main independent pro gnostic factor of relapse and survival in these women with stages I-II epit helial ovarian cancer. (C) 2001 by The American College of Obstetricians an d Gynecologists.