Characteristics of 10-year survivors of high-grade serous ovarian carcinoma

Abstract

Objective High-grade serous carcinoma (HGSC) generally presents at an advanced stage with poor long-term (LT) survival. Here we describe clinical features found in women surviving HGSC for ten or more years. Methods A multi-center research consortium was established between five participating academic centers. Patient selection criteria included high-grade serous ovarian, fallopian tube, or peritoneal carcinoma with at least ten years of follow up. Non-serous, borderline tumors and low-grade serous subtypes were excluded. Results The 203 identified LT ten-year survivors with HGSC were diagnosed at a median age of 57 years (range 37–84 years). The majority of patients had stage IIIC (72.4%) disease at presentation. Of those who underwent primary cytoreductive surgery, optimal cytoreduction was achieved in 143 (85.6%) patients. After a median follow up of 144 months, 88 (46.8%) patients did not develop recurrent disease after initial treatment. Unexpected findings from this survey of LT survivors includes 14% of patients having had suboptimal cytoreduction, 11% of patients having an initial platinum free interval of less than 12 months, and nearly 53% of patients having recurrent disease, yet still surviving more than ten years after diagnosis. Conclusions LT survivors of HGSC of the ovary generally have favorable clinical features including optimal surgical cytoreduction and primary platinum sensitive disease. The majority of patients will develop recurrent disease, however many remained disease free for more than 10 years. Future work will compare the clinical features of this unusual cohort of LT survivors with the characteristics of HGSC patients having less favorable outcomes.

Clinicopathologic characteristics associated with long-term survival in advanced epithelial ovarian cancer: an NRG Oncology/Gynecologic Oncology Group ancillary data study

“…Unfortunately the model’s predictive ability (AUC of 0.729) was insufficient for clinical utility as defined by the ability to discriminate long-term survivors sufficiently to alter patient management in ways that might ultimately improve outcomes [24]. Researchers from a multi-center research consortium investigating 10-year long-term survival highlighted the lack of predictability of clinical factors finding that 14% of long-term survival patients had suboptimal cytoreduction, 11% had an initial platinum free interval less than 12 months, and 53% had recurrent disease [19]. Though not evaluated in this analysis, successful prediction of long-term survivorship will likely depend on factors beyond currently recognized clinicopathologic characteristics.…”

Surgical readmission and survival in women with ovarian cancer: Are short-term quality metrics incentivizing decreased long-term survival?

“…Our study, as well as other retrospective studies of patients in the United States have found a survival benefit for primary debulking surgery among patients with stage IIIC disease (10, 11). These studies are subject to selection bias and confounding by indication, however, at this time, primary cytoreductive surgery for patients who are selected to undergo it, seems to be associated with the longest survival (21, 22). It is, therefore, possible that for patients with resectable disease, upfront cytoreductive surgery is associated with both increased short-term complications and increased long-term survival (23, 24).…”

Quality of life among long-term survivors of advanced stage ovarian cancer: A cross-sectional approach

“…Women with stage III disease have 5- and 10-year survival rates of 36% and 23%, respectively, with rates of 17% and 8% for stage IV disease [1]. Clinical predictors of long-term survival have recently been described [2]; however, quality of life (QOL) and survivorship concerns of long-term advanced-stage survivors have been minimally characterized, thus little is known about the needs of this population.…”

“…Although ovarian cancer patients have been surviving longer [9, 10] there has been minimal characterization of QOL needs of advanced-stage ovarian cancer patients surviving for 8.5 years or longer post-diagnosis. Furthermore, there is substantial heterogeneity in disease course among long-term survivors [2]. Although some live for many years recurrence-free and disease-free, others have multiple recurrences, and may have long-lasting intermittent treatment.…”