Comparison of the Predictive Power of Different Prognostic Indices for Overall Survival in Patients with Advanced Ovarian Carcinoma1

Validation of a 5-covariate prognostic index (PI;) (performance status, stage, residual tumor size, histolÃ3gica!grade, and ascitcs) derived from a group of 268 Dutch patients with advanced ovarian carcinoma was performed in a similar study of 301 Danish patients. Analysis of survival suggested an alternative 4-covariate PI (performance status, residual tumor size, age, weight/body surface) for the latter group. As residual tumor size and performance status were common to both indices, the predictive power of this 2-covariate PI (PI:) was also assessed in the Danish study and, subsequently, validated in the Dutch patients. The PI; defined 10 and 9% of the Dutch patients as low and high risk patients with 3-year survival rates of 80 and 8%, respectively. In the Danish study the PI; classified 14% to be high risk patients with a 3-year survival rate of 18%. Only a few patients (3%) were classified as low risk, making comparisons irrelevant. The l'I., classified 33 and 26% of the Danish patients as having 3-year survival rates of 67 and 13%, respectively. The corresponding Dutch PI2 values were 41 and 15% of the patients with 3year survival rates of 60 and 8%, respectively. Although the PI; possessed a better validity in the Danish study than the IM.,in the Dutch study, the IM..may be the best prognostic index available for general use.