Histology and Grade

Patients with mucinous, endometrioid, and mesonephric ovarian cancers have the best prognosis, all with 5-year survival rates higher than 50%. On the other hand, the serous papillary and anaplastic variant cancers are associated with much worse prognoses, with 5-year survival rates of 34% and 29%, respectively.51 Serous and mucinous tumors of low malignant potential have excellent survival rates. When comparing survival in patients with low malignant potential tumors of serous and mucinous variety with survival in women with invasive carcinoma, the overall relative

Figure 1-2. Survival rates for ovarian cancer by stage at diagnosis, all races, all ages. (From SEER 9 Registries for 1988-2002.)

survival rates at 10 years for low malignant potential-serous tumors are 98% compared with 31% for women with invasive serous cancers. For women with low malignant potential-mucinous tumors, the 10-year survival rate was 95% compared with 65% for women with mucinous carcinoma. For distant-stage disease, survival rates were between 86% and 90%.52 Histologic grade of tumor is an important prognostic factor in early-stage disease. Patients with stage I disease with poorly differentiated tumors have worse survival and need adjuvant therapy compared with patients with well-differentiated tumors. The 5-year survival rates for women with early-stage ovarian cancer (I and II) are 90%, 80%, and 75% for grades 1, 2, and 3, respectively. For advanced ovarian cancer (stage III and IV), the reported 5-year survival rates are 57%, 31%, and 28%, respectively.53

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