Long-term follow-up and prognostic factor analysis in advanced ovarian carcinoma: the Gynecologic Oncology Group experience.

Abstract

Long-term follow-up was obtained on 726 women with advanced ovarian carcinoma (suboptimal stage III and stage IV) who had received primary chemotherapy on two Gynecologic Oncology Group (GOG) protocols between 1976 and 1982. The first study compared melphalan alone versus melphalan plus hexamethylmelamine versus cyclophosphamide plus doxorubicin (CA). The second study evaluated the same CA regimen with or without cisplatin. Eligibility for the two studies was the same. At last contact, 76 patients were alive. In a multivariate analysis, cell type other than clear cell or mucinous, cisplatin-based treatment, good performance status, younger age, lower stage, clinically nonmeasurable disease, smaller residual tumor volume, and absence of ascites were favorable characteristics for overall survival (P less than .05). Second-look laparotomy was negative significantly more often among those with endometrioid tumors; there were no negative second-look laparotomies among those with mucinous or clear cell tumors. There were 30 patients with suboptimal stage III disease who had a negative second-look laparotomy; 18 (60%) have experienced recurrence, and 13 (43%) have died. Although cisplatin treatment was beneficial, new treatments are clearly needed.

Ovarian cancer in younger vs older women: a population-based analysis

“…Nonetheless, several other published studies have specified age as a significant prognostic factor, with older patients faring less well than younger women (Smedley and Sikora, 1985;Swenerton et al, 1985;Yancik et al, 1986;Omura et al, 1991;Gloecker-Ries, 1993;Thigpen et al, 1993;Kosary, 1994;Rodriguez et al, 1994;Lee et al, 1999;Brun et al, 2000;Schildkraut et al, 2000;Barnholtz-Sloan et al, 2003;Chan et al, 2003;O'Malley et al, 2003).…”

Obesity and Ovarian Cancer Survival: A Systematic Review and Meta-analysis

“…This poor survival is largely attributable to the fact that approximately 75% of all cases of ovarian cancer in developed countries are diagnosed with metastatic spread beyond the pelvis (1,2). While stage of disease at diagnosis remains the most important predictor of survival time, other known prognostic factors include age at diagnosis, tumor grade, and the amount of residual disease following surgery (3,4). However, at the time of diagnosis, none of these factors are amenable to intervention to improve survival.…”

Toward the development of a universal grading system for ovarian epithelial carcinoma

“…In that report, we proposed that a new grading system considering these three independent variables, (GOG) study demonstrated that the mucinous and clear cell histologic types, both of which were platimodified from a similar system used for breast carcinoma, that might be applicable for all histologic types num-resistant, were significantly poor prognostic factors in patients with Stage III and IV ovarian cancer. 5 of ovarian carcinoma should be established. The current report documents a universal histopathologic Conversely, some investigators have reached the conclusion that differences in survival between the histograding method for all patients with ovarian carcinoma and demonstrates its value as an independent logic subtypes disappeared completely when corrected for stage.…”

“…[2][3][4][5] A Gynecologic Oncology Group data). In that report, we proposed that a new grading system considering these three independent variables, (GOG) study demonstrated that the mucinous and clear cell histologic types, both of which were platimodified from a similar system used for breast carcinoma, that might be applicable for all histologic types num-resistant, were significantly poor prognostic factors in patients with Stage III and IV ovarian cancer.…”