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.