Swedish researchers have, for the first time, used a combination
of methods to accurately diagnose high-risk patents with early-stage
ovarian cancer, thereby identifying those who would benefit from
more aggressive treatment.
Historically, physicians have had difficulties in identifying
high-risk patients from among women with early-stage ovarian cancer.
Overall, 75% of these patients survive, but about 25% will still
die from the disease. Patients with a poor prognosis can be treated
with chemotherapy and radiation therapy.
The results of the study were presented by Dr. Nina Einhorn of
the Department of Gynecological Oncology, Karolinska Institute,
Stockholm, Sweden, at the American Radium Society's annual meeting,
held in Paris. Based on a 10-year follow-up of 95 ovarian cancer
patients treated for early stages of the disease, Dr. Einhorn
and colleagues found that by using a combination of biologic,
morphologic, and clinical methods they could accurately determine
whether such patients would benefit from aggressive treatment.
The biologic methods included image DNA analysis and the examination
of cell growth activity and gene products that are involved in
cell growth, such as tumor-suppressor gene p53 and the Waf-1 gene.
Genetic instability, as reflected by DNA aneuploidy, extensive
cell growth, and mutation of the p53 gene, indicated a high-risk
patient. Aggressive treatment is probably the only way to save
these patients' lives, according to Dr. Einhorn.
"We believe that by using this combination of methods we
have developed the most accurate and useful way to see if the
cancer needs to be treated," she said. "What we have
done is simply to find a new way to look at the diagnostic problem.
If we have a better way to diagnose these early cases, we can
better treat them."
Other Karolinska investigators who took part in the study were
Drs. Gert Auer, Claes Silfversward, and Kerstin Sjovall of the
departments of gynecology, pathology,and gynecological oncology.