Ovarian cancer is a tumor that grows at a rate of 80-90% in the ovarian surface epithelium, and can develop in any ovarian structure cell type . Epithelial ovarian cancer is serous 75%, 20% mucinous, endometroid 2%, less than 1% clear cell and Brenner tumor less than 1% remaining undifferentiated tumor. The tumor is diagnosed more frequently in 55-59 year old women . Together with malignant tumors there are the borderline tumors (low malignant potential), a group of malignancies other than benign or malignant.

Their evolutionary potential is enigmatic, their pathogenesis unclear, controversial clinical behavior, especially for serous type, which is the most common matter of fact. The absence of noticeable symptoms of early ovarian cancer is called "the silent killer." Being located deeply, the moderate increase in the volume of the ovaries does not cause symptoms.

The ovarian cancer has an unfavorable prognosis 70% of the advanced cases. The rate of recurrence after initial treatment is of 60% (Ozols1999). It seems that the survival rate of 5 years increased from 39% to 43% and the average survival from 29 to 39 months post cisplatin in treatment and surgical option conducted it more aggressively. Introduction in 1990 has significantly improved paclitaxel complete initial response from 31% to 51% and survival from 24 to 38luni (McGuire 1996).



Although many advances have been made in the last 20 years in understanding the biology and the therapeutic approach of epithelial ovarian cancer, they all have a major impact on long-term survival of patients. This is, in part, perhaps due to an insufficient appreciation of multiples and variability prognostic factors contributing to the development of ovarian cancer patients and inappropriate choice of therapeutic options. Not taking into account the prognostic factors lead to misinterpretation of therapeutic trials.

These problems are recognized and in the last decade have focused not only objective to identify new potential prognostic factors, but also to incorporate known prognostic factors clinicopatologici in multivariable models, which could provide better development of patients. With few exceptions, is still a long way to go to individual therapy in ovarian cancer patients according to risk of recurrence and therapeutic benefits.

Prognostic factors and diagnoses are defined as phenotypes correlated with survival. They generally reflect the intrinsic biology of the tumor, the patient's ability to interact with the morbidity. Prognostic factors in ovarian cancer established tumor behavior and treatment, impact type of treatment set (its effect on tumor and patient) Absence of an effective program of screening, high mortality caused by this disease, advanced stage at diagnosis require quantification of prognostic factors to determine an appropriate course to increase survival of these patients, which justifies the choice of this theme study.



Prognostic factors  and diagnoses can be grouped after Friedlander as follows:

Clinicopathological:
- FIGO Stage
- Torn capsule (early)
- Density adhesions (early
- Grading
- Histological Type
- Residual Disease
- Ascites
- Peritoneal cytology
- Patient status (associated diseases)
- Age

Quantitative histology:
-DNA ploidy
- The index of mitotic activity
- The percentage volume of epithelial
- Nuclear area (standard deviation)

Proliferation markers:
- Phase-S
- PCNA
- Ki67
- Thymidine synthase

Tumor markers:
- CA125
- CA54/61
- LDH
- CPK-BB
- CSF-1

Therapy - Multidisciplinary team
- Regime based on cisplatin
- Cisplatin-paclitaxel combination

Molecular genetic markers
- Her-2 neu
- P53
- BCL-2
- NM23
- BRCA1

-Markers of drug resistance
-Pi-GST (glutathione S transferase pi)
-MRP
-LRP
-MDR1 (multidrug rezistence) -ERCC
-Laminin
-Cathepsin D

Variable factors
-Tetranectina
-Hormone-receptor