Prognostic importance of DNA ploidy and p53 in early stages of epithelial ovarian carcinoma

Patients with early stages (FIGO stages 1A-IIC) of ovarian cancer continue to experience tumor relapses and they succumb due to their disease after se emingly adequate adjuvant therapy. In a series of 113 patients treated with adjuvant radiotherapy 4-6 weeks after primary surgery, the DNA content and p53 status of the tumors were studied and related to other known prognosti c factors (age, FIGO stage, histopathologic type, and tumor grade). The DNA analyses were done by flow cytometry and p53 expression was studied by imm unohistochemistry on formalin-fixed and paraffin-embedded tissue. DNA analy ses of 103 tumors could be made and the p53 status was determined in 106 ca ses. Univariate analyses showed that both p53-positivity and aneuploidy of the ovarian tumors were strongly associated with tumor grade. There was als o a strong association between p53 expression of the tumors and DNA aneuplo idy (DNA index >1.10 and S-phase fraction > 11.5%). P53-positivity and tumo r grade were the only significant factors for the risk of tumor recurrence. DNA and p53 status alone were not adequate predictive factors to identify clinically relevant subgroups of patients who would benefit from adjuvant p ostoperative therapy. Tumor grade remains the most important prognostic fac tor with regard to the risk of tumor recurrence and the cancer-specific sur vival rate in early stage ovarian carcinoma. Overexpression of p53 also inc reases the risk of tumor recurrence.