Ovarian cancer: changes in patterns at diagnosis and relative survival over the last three decades

Barnholtz‐Sloan, Jill S.; Schwartz, Ann G.; Qureshi, Faisal; Jacques, Suzanne M.; Malone, John M.; Munkarah, Adnan

doi:10.1067/s0002-9378(03)00579-9

Cited by 176 publications

(128 citation statements)

References 20 publications

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“…Studies have shown that younger patients had tumours with higher microvascular density which may be associated with an improved response to paclitaxel/ platinum-based chemotherapy (Hartmann et al, 1994;Kosary, 1994;Chan et al, 2004). Our results reflect that of other studies showing that younger age is an independent prognosticator for improved survival (Yancik et al, 1986;Kosary, 1994;Rodriguez et al, 1994;Barnholtz-Sloan et al, 2003;O'Malley et al, 2003). Nevertheless, this current reports is one of the largest population-based studies that has evaluated the demographic and clinico-pathologic prognostic factors associated with the survival of younger women with ovarian cancer using detailed surgical staging and pathologic information.…”

Section: Discussionsupporting

confidence: 85%

“…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).…”

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confidence: 99%

“…Furthermore, most reports originated from academic institutions and clinical trials data with associated biases and outcomes that may not reflect the general population (Averette et al, 1995;Barnholtz-Sloan et al, 2003;Chan et al, 2003). Prior studies that have used data from national registries included information collected from 1973 to 1997 (Yancik et al, 1986;Kosary, 1994;Barnholtz-Sloan et al, 2003).…”

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confidence: 99%

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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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Section: Discussionsupporting

confidence: 85%

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confidence: 99%

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confidence: 99%

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

et al. 2006

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“…Previous reports on ovarian cancer survival estimates were based on patients diagnosed many years ago with outdated estimates (Young et al, 1990;Yancik, 1993). In addition, many of these reports were limited by the lack of International Federation of Gynecology and Obstetrics (FIGO) staging and histologic information (Brenner, 2002;Engel et al, 2002;Barnholtz-Sloan et al, 2003). This current report is one of the largest population-based studies that consist exclusively of early-stage epithelial ovarian cancer patients with histologic and surgical information.…”

Section: Discussionmentioning

confidence: 95%

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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“…Because of the nonspecific symptoms and the lack of early diagnostic methods, EOC is extremely difficult to diagnose at an early stage. Nearly 70% of patients are diagnosed at an advanced stage (FIGOⅡ-Ⅳ), with a survival rate of 30-40% (Cannistra et al, 1993;Barnholtz-Sloan et al, 2003;Qiu H et al, 2011); however, if diagnosed at a localized stage (FIGOⅠ), the 5-year survical rate is 93% (Schlaerth et al, 2009). Therefore, a study on the molecular mechanism underlying ovarian cancer progression, including a search for a related target gene, is important for early diagnosis and effective therapy for ovarian cancer.…”

Section: Introductionmentioning

confidence: 99%