Objective: To evaluate the prognostic value of flow cytometric DNA quantification and immunohistochemical expression of c-erbB-2 and p53, and traditional 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 samples were available for DNA quantification and immunohistochemical evaluation of c-erbB-2 and p53 overexpression. Most women (87%) had received cisplatin-based adjuvant chemotherapy.
Results: The median follow-up was 90 months (range 50-148 months). The 6-year overall disease-free survival rate was 70% (95% confidence interval [CI] 60%, 81%), and overall global survival was 77% (95% CI 67%, 87%). Multivariable 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 prognosis factors for relapse, and DNA content (OR 9.8, P <.001) as the main independent factor for survival. In stepwise discriminant analysis the combination of DNA content and stage provided a correct prediction of relapse in 78% of women.
Conclusion: Flow cytometric DNA quantification was the main independent prognostic factor of relapse and survival in these women with stages I-II epithelial ovarian cancer.