The prognostic significance of nuclear DNA content in malignant epithelial tumors of the ovary

Recent studies have indicated that the nuclear DNA content of certain malignant neoplasms can be used as an adjunct in predicting their biologic behavior. The DNA content of 99 ovarian carcinomas was determined by flow cytometric analysis of nuclei obtained from paraffin‐embedded tissue. Of the 99 tumors, 51 were diploid and 48 showed one or more aneuploid peaks. The 5‐year survival for patients with diploid tumors (50%) was significantly higher than for patients with aneuploid tumors (22%) (P <0.01). Other factors which significantly affected survival were clinical stage (P <0.001), tumor pattern grade (P <0.01), DNA index (P <0.01), the presence of ascites (P < 0.001), peritoneal carcinomatosis (P <0.0001), and residual tumor at second‐look laparotomy (P <0.05). Diameter of the primary ovarian tumor, diameter of the largest peritoneal implant before debulking, and the percent S‐phase had no significant correlation with survival. Of 16 patients with aneuploid tumors who underwent second‐look laparotomy, nine (56%) had residual tumor, compared to six of 22 of patients with diploid tumors (27%). Of seven patients with aneuploid tumors and a negative second‐look laparotomy, four (57%) died from recurrent tumor. By comparison, of 16 patients with diploid tumors and a negative second‐look laparotomy, only four (25%) died from recurrent tumor. The determination of DNA ploidy in ovarian carcinomas may be used as an adjunct in predicting tumor behavior, response to chemotherapy, and late recurrence of disease.