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  • Articles: DFG German National Licenses  (2)
  • adjuvant chemotherapy  (1)
  • nm23  (1)
  • 1
    ISSN: 1569-8041
    Keywords: adjuvant chemotherapy ; DNA ploidy ; early ovarian cancer ; intergroup prospective trials
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose:Adjuvant chemotherapy versus observation and chemotherapyat progression was evaluated in 162 patients in a prospective randomizedmulticenter study. We also evaluated DNA-measurements as an additionalprognostic factor. Patients and methods:Patients received adjuvant carboplatin AUC7 every 28 days for six courses (n = 81) or no adjuvant treatment(n = 81). Eligibility included surgically staged and treated patientswith FIGO stage I disease, grade 1 aneuploid or grade 2 or 3 non-clear cellcarcinomas or clear cell carcinomas. Disease-free (DFS) and disease-specific(DSS) survival were end-points. Results:Median follow-up time was 46 months and progression wasobserved in 20 patients in the treatment group and 19 in the control group.Estimated five-year DFS and DSS were 70% and 86% in thetreatment group and 71% and 85% in the control group. The hazardratio was 0.98 (95% confidence interval (95% CI):0.52–1.83) regarding DFS and 0.94 (95% CI: 0.37–2.36)regarding DSS. No significant differences in DFS or DSS could be seen when thelog-rank test was stratified for prognostic variables. Therefore, data fromboth groups were pooled for the analysis of prognostic factors. DNA-ploidy(P = 0.003), extracapsular growth (P = 0.005), tumor rupture(P = 0.04), and WHO histologic grade (P = 0.04) weresignificant independent prognostic factors for DFS withP 〈 0.0001for the model in the multivariate Cox analysis. FIGO substage (P =0.01), DNA ploidy (P 〈 0.05), and histologic grade (P =0.05) were prognostic for DSS with a P-value for the model 〈0.0001. Conclusions:Due to the small number of patients the study wasinconclusive as regards the question of adjuvant chemotherapy. The survivalcurves were superimposable, but with wide confidence intervals. DNA-ploidyadds objective independent prognostic information regarding both DFS and DSSin early ovarian cancer.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1569-8041
    Keywords: cathepsin-D ; nm23 ; ovarian cancer ; prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Different regulators or effectors of the metastatic cascade can be of prognostic and/or predictive significance. Cathepsin-D and nm23 operate at different levels of the metastatic process and have not yet been analyzed in combination in ovarian cancer. Patients and methods: The prevalence of cathepsin-D and nm23 expression was studied with immunohistochemistry in a cohort of 185 previously untreated cases of FIGO stage III ovarian cancer. Correlations with known prognostic factors were examined, and both uni- and multivariate survival analyses were performed. Results: Epithelial cell cathepsin-D expression was found in 58% of cases, stromal cell cathepsin-D expression in 20%, and nm23 expression in 72%. Epithelial cell cathepsin-D expression was positively correlated with better differentiation of the tumor tissue (P = 0.034). No correlation was found between epithelial and stromal cell cathepsin-D expression, but a striking degree of positive correlation was demonstrated between epithelial cell cathepsin-D and nm23 expression (P = 0.005). None of the factors studied was of any value in predicting the response to platinum and anthracyclin combination chemotherapy, as assessed by second look laparotomy. In univariate analysis age, FIGO substage, histological type, differentiation grade, ascites, residual disease and epithelial cathepsin-D were associated with corrected survival. Neither stromal cell cathepsin-D, nor nm23 expression were of prognostic significance. However, in multivariate analysis the combination of epithelial and stromal cell cathepsin-D expression (P = 0.030), residual disease (P = 0.002) and differentiation grade (P = 0.007) were the only remaining independent prognostic factors in this patient group. Conclusions: Our results support a favourable prognostic significance of cathepsin-D expression in advanced ovarian cancer, but underscore the importance of considering both epithelial and stromal cell expression. We could not confirm the prognostic significance of nm23 expression in the present cohort of advanced ovarian cancer patients.
    Type of Medium: Electronic Resource
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