Prognostic factors for surgical outcome and survival in 447 women treated for advanced (FIGO-stages III-IV) epithelial ovarian carcinoma

Abstract

Abstract. The objectives of this population-based, retrospective study, was to find predictive factors for surgical outcome and long-term survival in 447 patients with epithelial ovarian cancer in FIGO-stages III-IV treated during 1975. The median overall survival rate of this series was 18 months, the 5-year cancer-specific survival rate was 18%, and the 5-year overall survival rate, 16%. In a logistic regression analysis, type of surgeon was the strongest (P=0.006) predictive factor for surgical outcome after the age of the patient. The optimal debulking rate was 36% for gynecologic oncologists, 29% for general gynecologists, 24% for combined gynecologist and obstetrician with the third level of specialization, and 4% for general surgeons. Optimal debulking (no visible tumor or residual tumor <2 cm) was achieved in 26% of the cases. Predictive factors of the outcome of cytoreduction were FIGO-stage (P=0.007), histological subtype (P=0.016), and tumor grade (P=0.046) in univariate analyses. In a Cox multivariate analysis the most important prognostic factor for overall survival was the amount of residual cancer (P=0.000001) before age, grade and stage. Therefore, to achieve optimal surgical outcome and optimal overall survival rate the primary surgery of advanced ovarian cancer should be performed by gynecologic oncologists or by gynecologists specially trained in gynecologic cancer surgery.

Predicting the Response of Advanced Cervical and Ovarian Tumors to Therapy

“…Residual disease after surgery for ovarian cancer can also strongly predict overall survival; to achieve optimal surgical outcome and optimal overall survival, the primary surgery of advanced ovarian cancer should be performed by gynecologic oncologists or by gynecologists specially trained in gynecologic cancer surgery (19,20). Recently, pretreatment white blood cell subtypes were investigated as indicators of adverse outcome in patients with ovarian cancer, with a high monocyte and eosinophil count found to be predictive of later recurrence (21).…”

Ovarian Cancer Cytoreductive Surgery in the Elderly

“…Cytoreductive surgery, also called debulking, is defined as the surgical removal of large volume disease, and has been associated with improvement in response to subsequent chemotherapy, and better overall survival [1][2][3][4][5].…”

Patterns of care in surgery for ovarian cancer in Europe

“…Population based data on the number of advanced ovarian cancer patients operated by a gynaecological oncologist are available in the literature for Sweden [22], Finland [23], Switzerland [24], United Kingdom [25][26][27], Denmark [28], the Netherlands [29] and Norway [30]. Data are summarised in Table 1.…”