Annals of Oncology 14:1494-1500, 2003
© 2003 European Society for Medical Oncology
Original Paper |
Large-scale genomic instability predicts long-term outcome for women with invasive stage I ovarian cancer
1 Department of Gynecologic Oncology and 2 Department of Pathology, The Norwegian Radium Hospital, Oslo, Norway; 3 Department of Gynecologic Oncology, University Hospitals Leuven, Leuven, Belgium; 4 Division of Genomic Medicine, University of Sheffield, Sheffield, UK
Received 6 November 2002; revised 8 May 2003; accepted 3 June 2003
Background:
The objective was to evaluate the value of DNA ploidy using high-resolution image cytometry in predicting long-term survival of patients with early ovarian cancer.
Patients and methods:
A retrospective analysis of 284 cases with FIGO stage I ovarian carcinoma treated during the period 1982–1989 was performed. Clinical follow-up information was available for all patients.
Results:
Patients with diploid and tetraploid tumors had a 10-year relapse-free survival of 95% and 89%, respectively, compared with 70% and 29% for polyploid and aneuploid tumors, respectively. DNA ploidy analysis was the strongest predictor of survival in multivariate analysis (diploid/tetraploid versus polyploid/aneuploid; relative hazard 9.0) followed by histological grade, including clear cell tumors in the group of poorly differentiated tumors (grade 1–2 versus grade 3 or clear cell; relative hazard 2.7), and FIGO stage (Ib/Ic versus Ia; relative hazard 2.0). In a stratified Kaplan–Meier analysis, patients with grade 1–2, diploid or tetraploid tumors had a 10-year relapse-free survival of 95%, forming a low-risk group. Patients with grade 3 or clear cell, diploid or tetraploid tumors had 10-year relapse-free survival of 86%, forming an intermediate-risk group, while all patients with aneuploid/polyploid tumors formed a high-risk group, with 10-year relapse-free survival of 34%.
Conclusions:
This study points to the importance of including DNA ploidy analysis by image cytometry when selecting patients with early ovarian cancer for adjuvant treatment after surgery.
Key words: DNA ploidy, image cytometry, ovarian neoplasms, prognosis
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