Conditional Probability of Survival and Prognostic Factors in Long-Term Survivors of High-Grade Serous Ovarian Cancer

Abstract

Objective: High-grade serous ovarian cancers (HGSOC) are heterogeneous, often diagnosed at an advanced stage, and associated with poor overall survival (OS, 39% at five years). There are few data about the prognostic factors of late relapses in HGSOC patients who survived ≥five years, long-term survivors (LTS). The aim of our study is to assess the probability of survival according to the already survived time from diagnosis. Methods: Data from HGSOC patients treated between 1995 and 2016 were retrospectively collected to estimate the conditional probability of survival (CPS), probability of surviving Y years after diagnosis when the patient had already survived X years, and to determine the LTS prognostic factors. The primary endpoint was OS. Results: 404 patients were included; 120 of them were LTS. Patients were aged 61 years (range: 20–89), WHO performance status 0–1 in 86.9% and 2 in 13.1%, and Fédération Internationale de Gynécologie et d’Obstétrique (FIGO) staging III and IV in 82.7% and 17.3% patients. Breast cancer (BRCA) status was available in 116 patients (33% mutated), including 58 LTS (36% mutated). No macroscopic residual disease was observed in 58.4% patients. First-line platinum-based chemotherapy plus paclitaxel was administered in 80.4% of patients (median: six cycles (range: 1–14)). After a 9 point 3-year follow-up, median OS was four years (95% CI: 3.6–4.5). The CPS at five years after surviving one year was 42.8% (95% CI: 35.3–48.3); it increased to 81.7% (95% CI: 75.5–87.8) after four survived years. Progression-free interval>18 months was the only LTS prognostic factor in the multivariable analysis (hazard ratio (HR) = 0.23; 95% CI: 0.13–0.40; p < 0.001). Conclusion: The CPS provided relevant and encouraging clinical information on the life expectancy of HGSOC patients who already survived a period of time after diagnosis. LTS prognostic factors are useful for clinicians and patients.

The Long-Term Prognostic Significance of Circulating Tumor Cells in Ovarian Cancer—A Study of the OVCAD Consortium

“…Given the fact that FIGO I stages were not included in the OVCAD patient cohort, the percentage of patients surviving 10 years or even longer is at least comparable with the 10-year survival rates reported from other studies, which generally include all stages [ 3 , 30 , 31 ]. The strong association of a long progression-free interval and long-term survival in our study is in line with a recent report [ 32 ]. A second major finding was that all patients alive 10 years after diagnosis were assigned as CTC combo -negative six months after the completion of the adjuvant treatment.…”

Search for New Participants in the Pathogenesis of High-Grade Serous Ovarian Cancer with the Potential to Be Used as Diagnostic Molecules

“…Serous ovarian cancer accounts for 75-80% of ovarian malignancies. A better understanding of the pathogenesis and molecular classi-fication of ovary cancer is urgently needed because the mortality rate has remained high and five-year survival rates are low; in particular, for the dominant tumor histologic type in epithelial ovarian cancers, HGSOC, these values are approximately equal to 40.6% [65] or to 70-80% [66].…”

Recent Advances in Ovarian Cancer: Therapeutic Strategies, Potential Biomarkers, and Technological Improvements

“…A number of barriers to the treatment of the disease exist [ 5 , 6 ]. Despite the early high rates of response to initial chemotherapy and radical surgery for about 70% of patients with relapses and intermediate progression-free 12- to 18-month survival, long-term survival remains poorly understood, with a high risk of reappearance [ 7 ]. Additionally, chemotherapeutic treatments for OC have an undesirable impact on quality of life because of their severe side effects, including fatigue, arthralgia, and neurotoxicity [ 8 , 9 ].…”