Patients with early stages (FIGO stages IA-IIC) of
ovarian cancer continue to experience
tumor relapses and they succumb due to their disease after seemingly 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 prognostic factors (age, FIGO stage, histopathologic type, and
tumor grade). The
DNA analyses were done by flow cytometry and p53 expression was studied by immunohistochemistry on
formalin-fixed and
paraffin-embedded tissue.
DNA analyses of 103
tumors could be made and the p53 status was determined in 106 cases. Univariate analyses showed that both p53-positivity and
aneuploidy of the ovarian
tumors were strongly associated with
tumor grade. There was also a strong association between p53 expression of the
tumors and
DNA aneuploidy (
DNA index >1.10 and S-phase fraction >11.5%). P53-positivity and
tumor 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 postoperative
therapy.
Tumor grade remains the most important prognostic factor with regard to the risk of
tumor recurrence and the
cancer-specific survival rate in early stage ovarian
carcinoma. Overexpression of p53 also increases the risk of
tumor recurrence.