A Population-Based 5-Year Cohort Study Including All Cases of Epithelial Ovarian Cancer in Western Sweden: 10-Year Survival and Prognostic Factors

Abstract

Epithelial ovarian cancer (EOC) is the major gynecologic cancer mortality cause in Sweden. The aim of the present study was to investigate the long-term survival and prognostic factors of a complete population-based 5-year cohort of 682 patients with invasive EOC in western Sweden (population around 1.6 million). Data relating to residual tumor after surgery, FIGO stage, grade, histopathologic subtype, ploidy status, adjuvant chemotherapy (the prepaclitaxel period), and disease state (recurrence and death) were reported to a quality register in a prospectively kept database and were controlled against the Swedish National Cancer Registry for completeness. The median follow-up durations for the prospectively collected data in the Cox analysis and for the survival analysis that was made for all patients were 81 months (range, 52-109 months) and 11.7 years (range, 8.7-14.1 years), respectively. No patient was lost to follow-up. The relative 10-year survival rate was 38.4% (95% confidence interval, 34.5%-42.8%). The median relative survival time was 4.3 years (95% confidence interval, 3.6%-5.2%). In the univariate Cox regression analysis, prognostic significances for age, stage, residual tumor, histopathologic subtype of serous cystadenocarcinoma, grade, CA-125, and ploidy status were seen. In the multivariate analysis, age, stage, residual tumor after surgery, and postoperative CA-125 were of prognostic significance. In conclusion, 4 major prognostic factors were found for EOC in this population-based cohort study that also presents nearly accurate long-term survival owing to the nonselective nature and completeness regarding patients and follow-up of the study.

Prognostic Factors Affecting Survival in Patients with Ovarian Cancer: A 5-Year Experience in an University Hospital.

“…The majority of studies show that comorbidities were found as the prognostic factors that influence the survival. 6,18,28,29 In a different study 20 , a high comorbidity score of ≥2 was associated with a decreased OS rates (HR, 1.5 [95% CI, 1.1-2.1]). When we performed our analyses, we either did found a relationship, higher comorbidity score was found to have poorer OS.…”

“…20 A Swedish study published in 2009 of 682 patients with epithelial OC found a 10-year relative survival rate of 38.4%, the median OS time was 81 months (52-109 months) in OC patients. 6 Larger population-based analyses of 10-year OS in OC have not been published in the Turkish populations. In a study performed in Turkey, according to the surgical stages I, II, III and IV median survival was 78.5 months, 60.1 months, 33.9 months and 16.1 months respectively and significantly different.…”

“…4,5 In the literature, survival depends on many factors such as patient's family history, multiple comorbidities, postoperative complications, chemotherapy toxicities, increasing age, postmenopausal period, recurrence, presence of positive lymph nodes, advanced stage and grade, carcinosarcomas subtype, ascites, never having been pregnant and having never taken oral contraceptives, as well as lifestyle factors such as performance status, smoking and obesity. [6][7][8][9][10][11] Statistics show that survival from all cancers in women was 64.2% while it was approximately 45.0% for OC globally and the 5-year survival rate has improved in OC by only 9% since 1975 even in high-income countries.…”

In vivo magnetic resonance spectroscopy for ovarian cancer diagnostics: quantification by the fast Padé transform

“…Cancers in this tiny organ are the sixth most often occurring malignancy among women throughout the world. In many parts of the world, including the U.S., Scandinavia and Israel, ovarian cancer is even more common, and in a number of countries the incidence of ovarian cancer appears to be increasing [2][3][4][5]. Ovarian cancer has a very high case fatality rate [6].…”

“…Transvaginal ultrasound (TVUS) and serum cancer antigen (CA-125) 2 have been the most commonly used diagnostic methods to screen for ovarian cancer. Recent evidence from a large, randomized controlled trial [the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS)] indicates that, compared to women who received no screening, there may have been reduced mortality from ovarian cancer during years 7 to 14 of the study among the women who received annual multimodal screening with serum CA-125 interpreted with use of the "Risk of Ovarian Cancer Algorithm".…”