The stage of the disease at the start of treatment is significant for the prognosis. The amount of tumor that remains after the operation, as well as the grade of differentiation and histologic type of the tumor tissue, is also of significance for the prognosis.
In stage I, the histological type, grade of differentiation, and ploidy are highly significant. Based on these parameters, tumors are separated into low and high risk groups:
- Low risk: Stage I a–c, grade 1–2, non-clear cell type and diploid
- High risk: Grade 3 or clear cell or aneuploid
Fallopian tube cancer
Important prognostic factors:
- Early stage: tumor rupture and depth of infiltration (in relation to serosal surface)
- Advanced stage: remaining tumor after primary operation
Five-year relative survival for patients with ovarian cancer, in percent, according to stage and diagnosis period 1974–2013.
Source: Cancer Registry of Norway
Multiple biological prognostic factors are correlated with prognosis of epithelial cancer types. Oslo University Hospital (The Norwegian Radium Hospital) has shown that epithelial ovarian cancers are often aneuploid. They have also shown a high correlation between FIGO stage and ploidy. That is, early early stage ovarian cancer has a tendency towards diploid and advanced tumors have a tendency to be aneuploid. Patients with diploid tumors have a significantly longer median survival time than those with aneuploid tumors, which are five and one year(s) respectively. Multivariant analyses have shown that ploidy is an independent prognostic factor.
Survival in 321 patients with ovarial border-line tumors related to ploidy and stage.
In vitro clonogenic assay
A significant inverse correlation has been reported between clonogenic growth in vitro and survival. Multivariant analysis has found that clonogenic growth in a semisolid culture medium is a significant independent variable. The prediction model "extreme drug resistance assay" has suggested that it is possible to decide chemotherapy by evaluating platinum-sensitive and resistant tumors in vitro. This technique is used at the department for gynecological cancer at Oslo University Hospital (The Norwegian Radium Hospital). It is still unknown whether this method alone can predict or change the outcome of a primary or recurrence situation.