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

Department of Oncology, the Finsen Institute, Rigshospitalet, Department of Internal Medicine C, Bispebjerg Hospital, University Hospitals of Copenhagen, Denmark; Department of Probability and Statistics, University of Sheffield, England; and Department of Medical Statistics, Leiden University, Leiden, and Department of Oncology, Utrecht University Hospital, Utrecht, The Netherlands

Validation of a 5-covariate prognostic index (PI₅) (performance status, stage, residual tumor size, histological grade, and ascites) 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 (PI₂) was also assessed in the Danish study and, subsequently, validated in the Dutch patients. The PI₅ 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 PI₅ 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 PI₂ 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 3-year survival rates of 60 and 8%, respectively. Although the PI₅ possessed a better validity in the Danish study than the PI₂ in the Dutch study, the PI₂ may be the best prognostic index available for general use.

¹ Supported by grants from the Lykfeldt, the Haensch, the Wedell-Wedellsborg, and the Abrahamson Foundations, and the Danish Cancer Society.

² To whom requests for reprints should be addressed, at the Department of Oncology, The Finsen Institute, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.

Received 1/29/90.

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