National survey of ovarian carcinoma VI: Critical assessment of Current International Federation of Gynecology and Obstetrics Staging System

Nguyen, Hoa N.; Averette, Hervy E.; Hoskins, William J.; Sevin, Bernd‐Uwe; Peñalver, Manuel; Steren, Albert

doi:10.1002/1097-0142(19931115)72:10<3007::aid-cncr2820721024>3.0.co;2-n

Cited by 72 publications

(29 citation statements)

References 6 publications

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“…An estimated 25 580 new cases of ovarian cancer were diagnosed in the United States in the year 2004, with 16 090 deaths associated with this disease (Jemal et al, 2004). Despite advances in surgical and systemic treatment, the 5-year survival of advanced stage patients with ovarian cancer remains below 30% (Nguyen et al, 1993;Parker et al, 1996;Jemal et al, 2004;Ries et al, 2004). However, invasive epithelial ovarian cancer is largely a disease of postmenopausal women with reproductive-age women comprising only 20% of all patients (Smedley and Sikora, 1985;Swenerton et al, 1985;Plaxe et al, 1993;Rodriguez et al, 1994).…”

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confidence: 99%

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

et al. 2006

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To compare the clinico-pathologic prognostic factors and survival of younger vs older women diagnosed with epithelial ovarian cancer. Demographic, clinico-pathologic, treatment, and surgery information were obtained from patients with ovarian cancer from the Surveillance, Epidemiology, and End Results Program from 1988 to 2001 and analysed using Kaplan -Meier estimates. Of 28 165 patients, 400 were o30 years (very young), 11 601 were 30 -60 (young), and 16 164 were 460 (older) years of age. Of the very young, young, and older patients, 261 (65.3%), 4664 (40.2%), and 3643 (22.5%) had stage I -II disease, respectively (Po0.001). Across all stages, very young women had a significant survival advantage over the young and older groups with 5-year disease-specific survival estimates at 78.8% vs 58.8 and 35.3%, respectively (Po0.001). This survival difference between the age groups persists even after adjusting for race, stage, grade, and surgical treatment. Reproductive age (16 -40 years) women with stage I -II epithelial ovarian cancer who received uterine-sparing procedures had similar survivals compared to those who underwent standard surgery (93.3% vs 91.5%, P ¼ 0.26). Younger women with epithelial ovarian cancer have a survival advantage compared to older patients.

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confidence: 99%

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

et al. 2006

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“…These studies have shown that patients with early-stage disease have overall survival ranging from 60 to 100% (Nguyen et al, 1993;Kosary, 1994;Averette et al, 1995;Partridge et al, 1996;Creasman et al, 2003;Jemal et al, 2006). Previous reports on ovarian cancer survival estimates were based on patients diagnosed many years ago with outdated estimates (Young et al, 1990;Yancik, 1993).…”

Section: Discussionmentioning

confidence: 99%

“…In 2007, an estimated 22 430 new epithelial ovarian cancers were diagnosed in the United States and approximately one-third had FIGO (International Federation of Obstetrics and Gynecology) stage I and II disease with a survival rate ranging from 70 to 90% (Heintz et al, 2006;Jemal et al, 2006). Although the survival of early-stage disease is significantly higher than those with advanced cancers, approximately 20 -30% of patients with early-stage cancers will succumb to their disease (Nguyen et al, 1993;Hoskins et al, 1994;Kosary, 1994;Averette et al, 1995;McGuire et al, 1996;Heintz et al, 2006).…”

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The treatment and outcomes of early-stage epithelial ovarian cancer: have we made any progress?

et al. 2008

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The objective of this study is to determine the progress and trends in the treatment and survival of women with early-stage (I -II) epithelial ovarian cancer. Data were obtained from the SEER database between 1988 and 2001. Kaplan -Meier and Cox regressions methods were employed for statistical analyses. Of the 8372 patients, the median age was 57 years (range: 12 -99 years). A total of 6152 patients (73.4%) presented with stage I and 2220 (26.5%) with stage II disease. Over the periods 1988 -1992, 1993 -1997, and 1998 -2001, 3-year disease-specific survivals increased from 86.1 to 87.2 to 88.8% (P ¼ 0.076). The number of patients that underwent lymphadenectomy has increased significantly from 26.2 to 38.7 to 54.2% over the study period (Po0.001). Of those patients who underwent staging procedures with lymphadenectomy, there was no improvement in survival over the three study periods (from 93.2 to 93.5 to 93.1%; P ¼ 0.978). On multivariate analysis, younger age, nonclear cell histology, earlier stage, lower grade, surgery, and lymphadenectomy were significant independent prognostic factors for improved survival. After adjusting for surgical staging with lymphadenectomy, the year of diagnosis was no longer an important prognostic factor. In conclusion, the use of lymphadenectomy during surgery for early-stage ovarian cancer has doubled over the last 14 years. The marginal improvement in survival demonstrated over time is potentially attributed to the increased use of staging procedures with lymphadenectomy.

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“…This assertion has been supported by several recent publications (Jackson et al, 1997), particularly relating to ovarian cancer (Junoer et al, 1994;Kehoe et al, 1994). Ovarian cancer, the commonest gynaecological cancer, has a poor outcome, with a five-year survival of 30-40% (Nguyen et al, 1993). This has been attributed, in part, to late presentation of disease, with the majority of cases having extra-ovarian spread at diagnosis (Nguyen et al, 1996).…”

Section: Introductionmentioning

confidence: 85%

The surgical management of women with ovarian cancer in the south west of England

Olaitan

Weeks²,

Mocroft

et al. 2001

Br J Cancer

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SummaryThe surgical management of epithelial ovarian cancer in the South West of England was studied in the two years 1997-1998 in order to determine the factors that influence the outcome of surgery and to provide a baseline from which to assess the effect of centralisation of cancer services. All hospitals in the South West region of England participating in the Regional Cancer Organisation's longitudinal study of outcomes in gynaecological malignancies are included. Six hundred and eighty-two patients with epithelial ovarian cancer were registered with the RCO in the two-year study period. Five hundred and ninety-five women were offered primary cytoreductive surgery of which 438 were said to be optimally cytoreduced. Applying multivariate models to analyse the outcome of surgery, older patients (OR = 0.82 per 5-year increase in age, P = 0.0003), patients treated in hospitals managing fewer than ten cases of ovarian cancer per year (OR = 1.92, P = 0.02) and patients with FIGO stage 3 (OR = 0.02, P < 0.0001) or 4 (OR = 0.002, P < 0.0001) disease were less likely to be optimally cytoreduced. Gynaecological oncologists were 2.06 times more likely to attain optimal cytoreduction when compared to general gynaecologists and this was statistically significant (P = 0.01). The results from this study support the argument that limiting surgery for ovarian malignancy to specialised surgeons improves the extent of cytoreductive surgery. prior to the re-organisation of gynaecological cancer services, looking particularly at factors influencing the completeness of surgery at each stage of disease. This study, as well as providing a base-line against which future performance can be measured, enables us to estimate the increase in work load and the resource implications for the regional cancer centre if centralisation of ovarian cancer management is fully implemented. MATERIALS AND METHODSThe South and West Regional Cancer Organisation (RCO) Gynaecology Tumour Panel is constituted of a multidisciplinary team of experts involved in the management of gynaecological malignancies. In 1997, the RCO initiated a prospective longitudinal study of the management of gynaecological cancer to establish current patterns of care and facilitate development of services in the region (Jackson et al, 1997). A one-page minimum data-set for each major gynaecological cancer site was designed (Figure 1). After obtaining approval from all units managing gynaecological malignancies, copies of the minimum data set pro forma were circulated along with guidance notes that included outlines of American Society of Anesthesiologists (ASA) grading, FIGO staging, and histopathology information required. Treatment policies detailing accepted pre-operative and operative management of epithelial ovarian cancer were produced and circulated by the RCO to all participating hospitals (Appendix 1). To ensure uniform histopathological reporting, the RCO also circulated guidelines for participating histopathologists (Appendix 2). The clinician managing the case is re...

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National survey of ovarian carcinoma VI: Critical assessment of Current International Federation of Gynecology and Obstetrics Staging System

Cited by 72 publications

References 6 publications

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

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

The treatment and outcomes of early-stage epithelial ovarian cancer: have we made any progress?

The surgical management of women with ovarian cancer in the south west of England

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