[Assessment of different histoprognosis grading systems for primary ovarian cancer: 100 patients given the same treatment for primary ovarian adenocarcinoma].
BACKGROUND
Numerous grading systems have been proposed for invasive ovarian epithelial carcinoma. But, conflicting reports have been published addressing the value of grade as an independent prognostic factor.


METHODS
The present study investigated the consistency, reproducibility and prognostic value of four different grading systems in a series of 100 homogeneously treated (cytoreductive surgery & platinum based chemotherapy) patient. All the slides were reviewed in a double-blind manner by 3 pathologists, typed according to the WHO and graded. Multivariate assessment of survival time was performed with the Cox model.


RESULTS
Population parameters - mean age: 60 years, - stage (FIGO) III & IV 85% - survival: 5 years OS: stage III & IV=22,5%. No significant difference for survival was observed when the patients were classified with any of the 4 grades evaluated. Prognostic factors: age<60 (p<0,001), optimal surgery (p<0,01), n+(p<0,02), necrosis>50% (p<0,04), mitotic count<15MF/10HPF (p<0,03) and vascular invasion (p<0,03). Those 3 parameters were assigned to a new highly relevant grade. At multivariate analysis, it was significantly associated with DFS and OS (p<0,01).


CONCLUSIONS
Our grade is simple, useful for all histologic types, non subjective and reproducible. Further studies are warranted to confirm its clinical utility.
Penault-Llorca
F
F
Centre Jean Perrin, BP 392, 63011 Clermont-Ferrand Cedex. fpenault@cjp.u-clermont.fr
Levrel
O
O
Clémenson
A
A
Kwiatkowski
F
F
Pomel
C
C
Fouilhoux
G
G
De Latour
M
M
Curé
H
H
Déchelotte
P
P
Fonck
Y
Y
Dauplat
J
J
D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001808:Blood Vessels / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D008938:Mitosis; D009336:Necrosis; D009361:Neoplasm Invasiveness; D010051:Ovarian Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D011379:Prognosis; D015996:Survival Rate