Histologic and nuclear grading and stromal reactions as indices for prognosis in ovarian cancer.
Ovarian cancer is one of the most frustrating problems in gynecology. Each year about 14,000 new cases are diagnosed in the United States and almost 11,000 patients die from their ovarian cancer. The results from treatment are no better in 1973 than they were in the previous two decades; Early diagnosis is a matter of chance rather than a scientific method. Until early diagnosis can be made and treatment instituted with predictable promise for cure, attention must be directed to study the natural history of disease, its histologic and nuclear grading, as well as the stromal reaction of the cancer. This approach should further validate end results and, in the future, help improve the survival rate in ovarian carcinoma. With these criteria, 174 fresh cases were evaluated. The study showed that undifferentiated cancers were mainly in the unfavorable histologic and nuclear grades, while the better differentiated tumors were in the more favorable group. Mucinous cancers were characterized by the greatest number of tumors with favorable histologic and nuclear grades and generally had a better survival rate. Since the potency of tumors vary within a given stage, treatment should be tailored to the cancer rather than the stage of disease; In general, stage of disease was more important than histologic or nuclear grades in determining prognosis.