Clinicopathological profile of primary ovarian carcinomas

Abstract

Ovarian cancer is the sixth most common cancer worldwide and seventh most common cause of cancer mortality. Latest WHO classification (2014) classified ovarian carcinomas into serous, mucinous, endometrioid, clear cell, Brenner, poorly differentiated / undifferentiated carcinomas and carcinosarcomas. Shih and Kurman had first proposed classifying epithelial ovarian carcinomas into Type 1 and Type 2 based on the 2 main pathways of tumorigenesis. To classify primary ovarian carcinomas into type 1 and type 2 based on morphology and assessment of IHC expression in different types of ovarian carcinomas. To correlate the 2 subtypes with clinical parameters and prognosis. Retrospective observational cohort analysis of 96 cases diagnosed as primary ovarian carcinomas was done including pathologically proven primary ovarian carcinoma between April 2013 and March 2016. We collected data from hospital information system, used 5 immunohistochemical markers to classify the tumors & then followed up the patients. We found statistical significant difference for patient age, patient stage, CA125, type of surgery (IDS/PDS)between type 1 and type 2 tumors. There was a significant reduction in mean overall and progression free survival for patients with type 2 carcinomas, residual disease post surgery, higher stage & those which underwent debulking (p<0.05). From our study we would like to conclude that, the classification of primary ovarian carcinomas into type 1 and 2 can be done based on morphological features and immunohistochemical markers comprising ER, PR, WT1, p53 & Napsin A. Frequency data of types of tumors, stage in our population concords with that of other studies in world literature. Type 2 carcinomas showed higher patient age, more advanced stage, higher CA125 levels & comprised higher proportion of cases that underwent interval debulking (post NACT) than type 1 carcinomas. Type 2 carcinomas have both lower overall and progression free survival in our study population.