Conditional disease‐free survival rates and their associated determinants in patients with epithelial ovarian cancer: A 15‐year retrospective cohort study

Abstract

Background The most common type of ovarian cancer (OC) is epithelial ovarian cancer (EOC) which is the most lethal gynecologic malignancy in adult women. Aim This study aimed to determine the conditional disease‐free survival (CDFS) rates and their associated determinants in patients with EOC. Methods and results The clinical and demographic data of 335 patients with confirmed EOC at Motahari Clinic (Shiraz, Iran) were retrospectively reviewed and analyzed. Traditional DFS (TDFS) and CDFS were calculated using the Kaplan–Meier method and cumulative DFS estimates, respectively. To evaluate the effects of the prognostic determinants on the DFS of the patients, a multiple covariate Cox analysis using the landmarking method was applied. The 1‐ and 3‐year TDFSs were 81.1% and 47.0%, respectively, and decreased over time. At baseline, a higher stage tumor and endometrioid histology were associated with a higher risk of recurrence when compared to stage I and other histological subtypes, respectively. The hazard of recurrence for older women (age ≥55 years) was approximately twice and three times more than that of women aged <45 years at 1‐ and 3‐year landmark time points, respectively. Conclusion The age at diagnosis, defined by a cut‐off of 55 years, was a prognostic factor for the CDFS of EOC women. Moreover, patients with advanced‐stage EOC (ASEOC) (stages III and IV) and endometrioid histology had poorer CDFSs compared to those with early‐stage EOC (ESEOC) (stages I and II) and other histological types. In ESEOC patients with age at diagnosis of >55 years, CDFS gradually decreased in 3 years after remission which should be considered for follow‐up care decision‐making.

Efficacy and Safety of Paclitaxel and Carboplatin for Platinum-Sensitive Ovarian Cancer: A Systematic Review and Meta-Analysis

“…Ovarian cancer is the main cause of death from gynecologic tumors [18,19] as well as the ffth leading cause of cancer death in women [20]. Due to the anatomical characteristics of ovarian cancer, there are no specifc symptoms in its early stage and a lack of sensitive and specifc early screening methods [21], resulting in 70% of patients being diagnosed at an advanced stage [22,23].…”

Current Treatments and New Possible Complementary Therapies for Epithelial Ovarian Cancer

“…For example, patients with type II EOC had a significantly higher incidence of advanced disease (FIGO stages III/IV) than type I patients (79.8% vs. 38% respectively) being the overall survival and progression-free survival significantly higher in patients with type I tumours [ 24 ]. In addition, some studies have found a markedly higher mortality in patients with advanced mucinous and clear cell carcinoma, compared to higher survival rates of patients with HGS-EOC and endometrioid subtypes [ 25 , 26 ].…”

The Significance of Radiotherapy in Ovarian Clear Cell Carcinoma: A Systematic Review and Meta-Analysis

“…According to literature, the rates of 5-year OS were estimated to be 20-35% for serous, 40-63% for endometrioid, 40-69% for mucinous, 35-50% for clear cell, and 11-29% for undifferentiated, respectively. [8][9][10][11] OCCC was less prevalent type, typically occurred at younger age, diagnosed at earlier stage; survival outcomes were generally favorable in the early stage, while advanced OCCC portended poor prognosis, which was often attributed to its inherent resistance to platinum-based chemotherapy. [12][13][14] Staging surgery or cytoreduction was recommended for OCCC, complete surgery with no macroscopic residual disease was the basis for survival benefit, was the most important prognostic factor for OCCC, even mini residual disease might significantly damage prognosis.…”

“…According to literature, the rates of 5-year OS were estimated to be 20–35% for serous, 40–63% for endometrioid, 40–69% for mucinous, 35–50% for clear cell, and 11–29% for undifferentiated, respectively. 8 - 11 …”