Tumor DNA content as a prognostic feature in advanced epithelial ovarian carcinoma.

Tumor DNA content (ploidy) was determined in 84 patients with epithelial ovarian carcinoma. Stage II-IV. A total of 251 DNA histograms generated by flow cytometry on cells derived from paraffin-embedded specimens were analyzed retrospectively. Of the 84 patients, 44 had tumors which were aneuploid, whereas 33 had diploid, and 7 had tetraploid tumors. Cox regression analysis revealed that age (P less than 0.001), stage (P less than 0.001), and ploidy (P less than 0.001) were independent prognostic features. The median survival time was 19 months and 48 months, respectively, in aneuploid and euploid tumors (P less than 0.001). The size of residual after surgery lost its significance when corrected for stage. Multivariate analysis in Stage III tumors revealed that ploidy was the most important prognostic factor (P less than 0.001) followed by age (P less than 0.025). A remarkable stability of cellular DNA content was found when the primary tumor was compared to the following groups: (1) various metastatic specimens from the primary operation in the same patient; (2) specimens analyzed sequentially from primary, secondary, and tertiary exploratory laparotomy; and (3) peritoneal washings before and after intraperitoneal chemotherapy.