Prognostic evaluation of tumour type and other histopathological characteristics in advanced epithelial ovarian cancer, treated with surgery and paclitaxel/carboplatin chemotherapy: Cell type is the most useful prognostic factor

Dept. of Clinical Therapeutics, Medical School, University of Athens, Athens, Greece.
European journal of cancer (Oxford, England: 1990) (Impact Factor: 5.42). 10/2011; 48(10):1476-83. DOI: 10.1016/j.ejca.2011.09.023
Source: PubMed


Ovarian carcinomas have been classified into types I and II according to the hypothesised mode of carcinogenesis and molecular characteristics. The prognostic significance of this classification has not been studied.
Five hundred and sixty-eight patients with histologically confirmed, ovarian, fallopian tube or peritoneal carcinomas, international federation of gynecology and obstetrics (FIGO) stages IIC-IV, treated with paclitaxel/platinum following cytoreductive surgery, were included in this analysis. Type I included low-grade serous, mucinous, endometrioid and clear-cell and type II high-grade serous, unspecified adenocarcinomas and undifferentiated carcinomas.
Median overall survival (OS) was 49 months for type I versus 45 for type II (p=0.576). In contrast to type II, there was considerable prognostic heterogeneity among the subtypes included in type I. Cox regression analysis showed that cell-type classification: low-grade serous, mucinous, endometrioid, clear-cell, type II (high-grade serous, unspecified adenocarcinomas, undifferentiated carcinoma) was an independent predictor of survival (respective median OS 121 versus 15 versus 64 versus 29 versus 45 months, p=0.003). On the contrary, histopathological subtype or tumour type (I versus II) did not offer additional prognostic information.
The proposed model of ovarian tumourigenesis does not reflect tumour behaviour in advanced disease. Tumour-cell type is the most relevant histopathological prognostic factor in advanced ovarian cancer treated with platinum/paclitaxel.

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    • "The same controversies regarding prognosis are seen between studies analysing HLA-G expression in ovarian cancer. These controversies could be due to the fact that heterogeneous groups of patients were analysed [7] [36]. As HLA-G is frequently expressed in high grade ovarian tumours and almost never in low grade tumours, the role of this molecule could be different within these tumour types [37]. "
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    Research Journal of Immunology 05/2014; 2014:274584. DOI:10.1155/2014/274584
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    • "A large series study, conducted on 575 women affected by EOC, optimally surgically debulked without macroscopic residual disease, showed that tumor cell type was both more reproducible and provided superior prognostic information compared with assignment of tumor grade [26, 27]. Tumor-cell type was confirmed to be the most relevant histopathological prognostic also in patients treated with surgery and chemotherapy [28]. "
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    08/2013; 2013(2):852839. DOI:10.1155/2013/852839
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