Modifiable risk factors associated with long-term survival in women with serous ovarian cancer: a National Cancer Database study

Abstract

ObjectiveTo identify patient, clinical and hospital factors associated with long-term survival (≥10 years) in women with serous ovarian cancer.MethodsThis National Cancer Database cohort study included women with stage II–IV serous ovarian cancer. Multivariate logistic regression models were used to examine the association of long-term survival with patient (race, insurance, location, household income, education, distance traveled), clinical (age, comorbidities, stage, grade, primary treatment) and hospital factors (region, institution, hospital volume ≥20).ResultsOf the 4640 women identified, 12% (n=561) experienced long-term survival. Median overall survival was 41 months (95% CI 39 to 42). The odds of long-term survival were lower for women with public or no insurance (adjusted OR 0.71, 95% CI 0.55 to 0.92), age ≥75 years (0.33, 0.22 to 0.50), any comorbidities (0.70, 0.54 to 0.92), higher stage (stage III: 0.31, 0.25 to 0.41; stage IV: 0.16, 0.12 to 0.22), and moderately/poorly differentiated, undifferentiated, or tumors of unknown grade (moderately/poorly differentiated: 0.30, 0.20 to 0.47; undifferentiated: 0.28, 0.17 to 0.47; unknown: 0.30, 0.18 to 0.50). The odds of long-term survival among women who were publicly insured were lower with neoadjuvant chemotherapy (0.13, 0.04 to 0.044) and higher with optimal cytoreduction (2.24, 1.49 to 3.36). Among women who were privately insured, the odds of long-term survival were higher with optimal cytoreduction (1.99, 1.46 to 2.70) and unaffected by neoadjuvant chemotherapy.ConclusionsWhile immutable clinical factors such as age, stage, and grade are associated with long-term survival in women with serous ovarian cancer, modifiable factors, such as insurance type, optimal cytoreductive status, and neoadjuvant chemotherapy provide an opportunity for targeted improvement in care with potential to affect long-term patient outcomes.

Association of pre-diagnosis specific color groups of fruit and vegetable intake with ovarian cancer survival: results from the ovarian cancer follow-up study (OOPS)

“…4 Certain unmodifiable disease-related factors have been shown to influence the prognosis of OC, thus, identifying preventive factors, especially modifiable ones, is a vital way to reduce morbidity and mortality for this disease. 5–7 Diet is a crucial modifiable prognostic factor that can be utilized to make suggestions for reducing OC mortality. Previous evidence has indicated that healthy components of a pre-diagnosis diet were associated with better OC survival, raising the possibility of healthy dietary choices after diagnosis.…”

Nomogram incorporating log odds of positive lymph nodes improves prognostic prediction for ovarian serous carcinoma: a real-world retrospective cohort study

“…Previous studies have identified potential factors that affect the prognosis of OSC patients. For instance, Frost et al 20 reported that younger age and lower tumour stage and grade were associated with longer survival in OSC patients who survived for over 10 years. Similarly, Lisio et al 21 and Shim et al 22 identified older age at diagnosis, higher grade and stage as independent prognostic factors for poor prognosis in OSC patients.…”