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Prognostic factors in ovarian carcinoma stage III patients. Can biomarkers improve the prediction of short- and long-term survivors?
  1. J. KAERN*,
  3. J. M. NESLAND,
  4. H. E. DANIELSEN§,
  7. C. TROPÉ*
  1. *Department of Gynecologic Oncology, University of Oslo, The Norwegian Radium Hospital, Oslo, Norway
  2. Department of Medical Oncology, Prince of Wales Hospital, Sidney, Australia
  3. Department of Pathology, University of Oslo, The Norwegian Radium Hospital, Oslo, Norway
  4. §Department of Medical Informatics, Division for Genomic Medicine, University of Sheffield, United Kingdom
  5. Clinical Research Office, University of Oslo, The Norwegian Radium Hospital, and The Norwegian Cancer Society, Oslo, Norway
  1. Address correspondence and reprint requests to: Janne Kaern, MD, PhD, Montebello, 0310 Oslo, Norway. Email: janne.karn{at}


The aim of the study was to determine if biomarker expression could help discriminate between short-term and long-term survivors in women with advanced ovarian cancer. Fifty-one patients with stage III ovarian cancer were selected for the study, which included 28 short-term survivors (death from ovarian cancer within 18 months) and 23 long-term survivors (alive for more than 5 years). There was no difference between the two groups with respect to FIGO substage, age, World Health Organization score, and first-line platinum therapy. Classic clinical pathologic parameters were examined together with p53, Bcl-2, Ki-67, PDGFRα, P-glycoprotein, BRCA1, and DNA ploidy. Immunohistochemistry was used for scoring biomarker expression and image cytometry for DNA ploidy. All patients had primary debulking surgery followed by first-line platinum therapy. On multivariate analysis, the presence of ascites, debulking surgery and repeat laparotomy, clear-cell histology, elevated CA125, and high Ki-67 score were all found to be of prognostic importance. The long-term survivors were characterized by primary optimal cytoreduction surgery (<1 cm residual disease), attempt at maximal tumor debulking by experienced gynecological oncologic surgeons, and the absence of ascites. Normal CA125 level before platinum therapy and negative Ki-67 expression also predicted a more favorable prognosis.

  • advanced ovarian cancer
  • long-term survival
  • prognostic factors

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