FLOW CYTOMETRIC EVALUATION OF OVARIAN-CANCER

Background. Despite recent advances in the treatment of ovarian cancer, the long-term prognosis for patients with this malignancy appears to depend more on tumor prognostic factors than on treatment regimens. The traditionally used prognostic factors are often subjective and, currently, have not been sufficient to determine individual patient prognosis. Methods. Newer techniques of quantitative cytologic testing, including flow cytometry, facilitate the objective evaluation of tumor cell heterogeneity and the identification of additional prognostic factors. Results. There is good evidence, mainly from retrospective studies, that DNA ploidy is a valuable prognostic indicator in patients with both early-stage and late-stage ovarian cancer. Most of the recent flow cytometric studies have identified ploidy as an independent prognostic factor, with aneuploidy predicting a significantly shorter survival time, even in patients with borderline malignant tumors. Flow cytometric determination of cell cycle information (e.g., S-phase fraction or proliferative index) may represent additional prognostic information and may be used to predict the early tumor response to treatment. Conclusions. Although additional prospective studies are needed to establish the exact value of flow cytometric evaluation for ovarian cancer and other gynecologic malignancies, there is little doubt that the prognostic value of this information will influence clinical management of patients with these malignancies in the near future.