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PIEPOC: A New Prognostic Index for Advanced Epithelial Ovarian Cancer—Japan Multinational Trial Organization OC01-01

Satoshi Teramukai, Kazunori Ochiai, Harue Tada, Masanori Fukushima

From the Department of Clinical Trial Design and Management, Translational Research Center, Kyoto University Hospital; and the Department of Gynecology, The Jikei University School of Medicine, Tokyo, Japan

Address reprint requests to Satoshi Teramukai, PhD, Department of Clinical Trial Design and Management, Translational Research Center, Kyoto University Hospital, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan; e-mail: steramu{at}kuhp.kyoto-u.ac.jp

Purpose The purpose of this study was to construct a simple and powerful prognostic index (PI) of epithelial ovarian cancer, the PIEPOC.

Patients and Methods In a retrospective review, data from 768 women with stage III or IV epithelial ovarian cancer from 24 institutions in Japan were evaluated for clinical features predictive of overall survival. A PI and risk groups to predict overall survival after initial surgery were developed using the proportional hazards regression model.

Results Of six factors, the four prognostic factors that remained independently significant in the analysis of a training sample (538 randomly selected patients) were age, performance status (PS), histologic cell type, and residual tumor size. From the regression function, we derived a PI = 1 (if age 70 and above) + 1 (if PS 1 or 2) + 2 (if PS 3 or 4) + 1 (if mucinous or clear-cell) + 2 (if residual size 0.1 cm and above). Patients were classified into three risk groups (PIEPOC): low risk (PI 0-2), intermediate risk (PI 3), and high risk (PI 4-6). The PIEPOC was equally predictive in a validation sample (n = 230), identifying three groups (5-year survival: 0.67 in low, 0.43 in intermediate, 0.17 in high risk).

Conclusion Our proposed PI, the PIEPOC, was predictive in our patient population and may have utility in clinical practice. Prospective studies would be needed to confirm the prognostic predictive ability of the PIEPOC for patients with advanced epithelial ovarian cancer.

Supported by the Japan Multinational Trial Organization.

Presented in part at the 42nd Annual Meeting of the American Society of Clinical Oncology, Atlanta, GA, June 2-6, 2006.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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Related Correspondence

• Validation of a New Prognostic Index for Advanced Epithelial Ovarian Cancer: Results From Its Application to a UK-Based Cohort
  Taane G. Clark, Moira Stewart, Tzyvia Rye, John F. Smyth, and Charlie Gourley
  JCO 2007 25: 5669-5670 [Full Text]

This article has been cited by other articles:

				T. G. Clark, M. Stewart, T. Rye, J. F. Smyth, and C. Gourley Validation of a New Prognostic Index for Advanced Epithelial Ovarian Cancer: Results From Its Application to a UK-Based Cohort J. Clin. Oncol., December 10, 2007; 25(35): 5669 - 5670. [Full Text] [PDF]

				S. Teramukai, H. Tada, M. Fukushima, and K. Ochiai In Reply J. Clin. Oncol., December 10, 2007; 25(35): 5670 - 5671. [Full Text] [PDF]