Influence of surgery and postoperative therapy and tumor characteristics on patient prognosis in advanced ovarian carcinomas.
OBJECTIVE
The prognosis in advanced ovarian cancer depends on clinical, morphological, biological and therapeutic variables. However, little is known about their real influences and interrelationships.


METHODS
One hundred and nineteen long-term, follow-up patients with advanced ovarian carcinoma were analyzed. Overall survival was related to the extent of debulking surgery, response to chemotherapy and several clinicomorphological, histopathological, and immunohistochemical variables.


RESULTS
Among all variables, both radical surgery and response to chemotherapy exerted the greatest influence on patient prognosis as shown in both univariate and multifactorial analyses. Most established prognostic factors were of minor importance. Success of chemotherapy correlated with lower residual tumor volume, CA125 expression, FIGO-stage, and serous tumor type.


CONCLUSIONS
Prognosis and chemotherapeutic success in advanced ovarian cancer seem to be interrelated and may be influenced by the intensity of surgical interventions. This demands for greatest cytoreduction during initial surgery and correction for residual tumor volume and success of therapy in studies of prognostic factors.
von Georgi
Richard
R
Department of Medical Sociology, Justus-Liebig-University of Giessen, Friedrichstrasse 36, D 35385 Giessen, Germany.
Franke
Folker E
FE
Münstedt
Karsten
K
D000970:Antineoplastic Agents / Q000627:therapeutic use; D018394:CA-125 Antigen / Q000032:analysis; D002272:Carcinoembryonic Antigen / Q000032:analysis; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis; D012044:Regression Analysis
D000970:Antineoplastic Agents; D018394:CA-125 Antigen; D002272:Carcinoembryonic Antigen; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone