Correlation between clinicopathological factors and clinical outcomes of recurrent epithelial ovarian cancer at a tertiary hospital in Surabaya, Indonesia

Abstract

Introduction: Ovarian cancer is one of the leading causes of cancer death in women globally. The objective of this study was to determine the correlation and the association between age, stage, histopathology, grade, ascites, tumor residual, CA-125 level, and type of surgery on recurrence, disease-free survival, overall survival and mortality of epithelial ovarian cancer patients. Methods: An analytical retrospective study using medical records and interviews of epithelial ovarian cancer patients was conducted in Dr. Soetomo Hospital. The study included the data from January 2016-December 2020. Kaplan-Meier and log-rank test were used to assess the factors associated with disease-free survival (DFS) and overall survival (OS). Results: A total of 358 patients with epithelial ovarian cancer from 2016 to 2020 were included in the study of which 153 of recurrence cases. Clinicopathological factors that correlated with disease-free survival were stage, histopathology, grade, ascites, tumor residual, CA-125, and type of surgery (p<0.05). The factors that correlated with overall survival were stage, histopathology, grade, ascites, residual tumor, and CA-125 value (p<0.05). The most significant factors associated with recurrence and mortality were stage, grade, and ascites. Stage II and III had an HR (hazard ratio) of 1.9 and 2.1 for recurrence compared to stage I, respectively. Grade II and III patients had HRs of 2.1, and 3.4 for recurrence compared to stage I, respectively. The presence of ascites had an HR of 1.5 compared to those had no ascites. Stage III had an HR of 1.9 for mortality compared to stage I, respectively. Grade II and III patients had HRs of 3.6, and 5.0 for death compared to stage I, respectively. The presence of ascites had an HR of 1.6 compared to patients with no ascites. Compared to serous type, those patients with mucinous and clear cell had HR of 1.8 and 3.1 for mortality, respectively Conclusion: Stage, grade, and ascites were the most significant factors in the incidence of recurrence and mortality of epithelial ovarian cancer.

Dynamic Changes in Body Composition and Protein Intake in Epithelial Ovarian Cancer Patients Undergoing Chemotherapy: A Preliminary Study

“…In 2020, there were approximately 207,252 reported cases of ovarian cancer globally, making it the third most common gynecologic cancer [ 1 , 2 ]. Specifically, in Indonesia, according to data from Globocan 2018, there are an estimated 13.310 new cases of ovarian cancer each year, with a high mortality rate [ 3 , 4 ].…”

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“…Ovarian cancer was the eighth most frequent cancer diagnosis and cause of death for women in 2018 [1]. It was characterized by tumor heterogeneity, early metastases, and resistance to therapy [2][3][4].…”