Radiotherapy in Epithelial Ovarian Cancer: Analysis of Prognostic Factors Based on Long-Term Experience

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Between 1956 and 1980, 152 patients with stages I, II, and III epithelial carcinoma of the ovary received lower abdominal or whole abdominal/pelvic megavoltage irradiation as the sole postoperative treatment. The prognostic factors of stage, amount of postoperative residual disease, histologic type, grade, and age were retrospectively analyzed. Mean follow-up was 6.0 years and survival and freedom from relapse are quoted at ten years. For the entire group, actuarial survival and freedom from relapse were 40 and 44%, respectively. Freedom from relapse for stages I, II, and III was 78, 58, and 16%, respectively. For patients with no residual disease, freedom from relapse was 73%; for those with minimal residual disease in which the largest mass was less than 2 cm, 48%; and for those with gross residual disease greater than 2 cm, 13%. The most frequently seen histologic types and their freedom from relapse rates were endometrioid (63%), serous (45%), and undifferentiated (7%). Histologic grade was termed well, moderately, or poorly differentiated with freedom from relapse rates of 87, 68, and 20%, respectively. Patients less than 40 years of age had a freedom from relapse rate of 80%, as compared with 36% for those 40 years or older. Multivariate analysis showed all factors to have individual prognostic significance, with histologic grade of greatest significance, atP= .002; age,P= .004; residual disease,P= .007; stage,P= .015; and histologic type,P= .021. Freedom from relapse for prognostic profiles based on the simultaneous correlation of grade, residual disease, and stage as well as patterns of relapse and a prognostic index based on multivariate analysis define those patients most suitable for whole abdominal/pelvic radiotherapy alone, and those who require other therapy.(Obstet Gynecol 62:373, 1983)

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