Effect of cellular DNA content on the prognosis of epithelial ovarian cancers

Objective: To assess the cellular DNA status of epithelia I ovarian cancers with regard to clinicopathological findings and its effect on prognosis. M aterials and Methods: Twenty-six consecutive patients with a diagnosis of e pithelial ovarian cancer who had been treated by primary surgery and six co urses of platinum-based chemotherapy were enrolled in this study. Second-lo ok laparotomy (SLL) was performed in all cases following confirmation of th e clinical remission state. Surgical stage, tumor grade, initial tumor volu me, residual tumor volume, histopathologic differentiation, and SLL finding s were analyzed in correlation with DNA ploidy and DNA index. DNA analysis was performed via DNA flow cytometry through paraffin-em bedded tissue spec imens. Results: Of 26 patients, flow cytometric studies revealed 16 aneuplo idy cases (61.5%). DNA index values ranged from 1.1 to 1.82 (average 1.29 /- 0.28). The flow cytometry coefficient of variation mean value was set to 6.7. Taking the cutoff value of 1.2 for DNA indices, a fairly good correla tion was detected between DNA ploidy and DNA indices (p < 0.001). The aneup loidy incidence was found to be high in advanced and poorly differentiated tumors (p < 0.05). There was statistically more residual tumor volume in an euploid tumors during primary cytoreductive surgery and also higher recurre nce rates following six courses of chemotherapy compared with diploid tumor s (p < 0.05). No significant correlation was detected between the histopath ologic subtypes and tumor volume (p > 0.05). Residual tumor volumes were la rger in cases with DNA indices of 1.2 yielding higher residual tumor volume following surgery and being in good correlation with SLL results (p < 0.05 ). The mean survival rates of cases with aneuploid tumor and a DNA index of >1.2 were low, compared to those with diploid tumors and DNA indices of < 1.2 tumors (p < 0.05). Conclusion: DNA ploidy and DNA indices are important prognosticators for malignant epithelial ovarian tumors. They should be ev aluated together with the patient's clinical status and other prognostic fa ctors. Copyright (C) 2001 S. Karger AG, Basel.