[Histologic classification and morphologic prognostic factors in malignant ovarian tumors].

Most cases of death in genital neoplasms of females are caused by ovarian cancer. Prognostic factors are the postoperative tumor, tumor stage (FIGO, pTNM), age, tumors among family, and the reproductive history. On the basis of 710 malignant ovarian tumors we describe the histogenetic classification and compare the morphologic diagnosis with additional prognostic factors by literature to give a practical review of ovarian neoplasms. The morphologic prognostic factors are the histological subtype, tumor grading and perhaps the receptor status. Worse prognosis, despite of tumor grading, show undifferentiated carcinomas, followed by the serous and mucinous subtype. Endometrioid carcinomas have the best prognosis. Malignant Mullerian tumors show a very aggressive behavior. After the introduction of polychemotherapy the sex-cord- and germ cell-tumors show better prognoses. New prognostic factors are DNA-parameters (ploidy, S-phase-fraction), detection of oncogenes and tumor suppressor genes, cellular adhesion molecules (integrins, CD 44-splicing variants), and the proliferation rate of the tumor. Perhaps, these factors show prognostic relevance for individual treatment. A correct histologic classification with consideration of all morphology related prognostic factors and the knowledge about them is necessary for oncologists to choose the optimal individual therapeutic treatment.