Long-term prognostic factors for chemotherapy of ovarian cancer.

Patients with progressive ovarian cancer who underwent a remission-induction therapy in our department; intermittent chemotherapy (IC) of CDDP was performed every 3 months, and good outcome has been obtained. However, ineffective cases are sporadically seen. As long-term prognostic factors influencing the IC, we studied glutathione S-transferase-pi (GST-pi) and silver-binding nucleolar organizer regions (AgNORs), and examined their changes during CDDP therapy immunohistologically to clarify their significance as long-term prognostic factors in CDDP therapy. In 58 patients who underwent postoperative CDDP therapy in the past 15 years, the prevalence of GST-pi was 79.3%, and the rate in the case of clear cell carcinoma was significantly higher than that in the case of serous cystadenocarcinoma. Among 37 patients with progressive ovarian cancer, patients for whom remission-induction was impossible, the prevalence of GST-pi expression and the number of NORs were significantly large. In the comparison between before and after the remission-induction, elevation in the staining score of GST-pi was found in 83.3%, and an increase in NORs number was seen in 50%. On the other hand, in the patients who showed aggravation in the IC group, 5 patients underwent second look operation, and all of them showed elevation in the staining score of GST-pi and 4 of them showed increase in NORs number. Therefore, examination of GST-pi and the number of NORs wes considered to be useful in suggesting prognosis for progressive ovarian cancer, particularly the case having IC.