Objective. The incidence of initial diagnosis with distant metastasis in patients with epithelial ovarian cancer is not rare, for which the available prognostic evaluation criteria is absent. This study aimed to develop a nomogram score to predict long-term prognosis.Methods. This study analyzed patients with epithelial ovarian cancer from the Surveillance, Epidemiology, and End Results (SEER) database between 1975 and 2016. Multivariable logistic and Cox regression were performed to identify survival trajectories. A nomogram score was used to predict long-term survival probability. Results. A total of 131050 patients were included, 18.2%, 7.8% and 66.1% had localized, regional and distant metastases, respectively. Metastases were inversely associated with high probability of 5-year overall survival outcome, localized (OR, 4.62; 95%CI, 4.45-4.80), regional (OR, 2.47; 95%CI, 2.36-2.59) compared with distant metastases. Survival was poorer among regional (HR, 1.72; 95%CI, 1.65-1.79) and distant (HR, 3.39; 95%CI, 3.29-3.49) metastases at diagnosis. For incidence, 0.9%, 6.7%, 5.8% and 0.2% had bone, liver, lung and brain metastases in the all-cause mortality cohort respectively, 1.6%, 9.9%, 8.8% and 0.3% had bone, liver, lung and brain metastases in the cancer-specific mortality cohort respectively. The median survival among the all-cause mortality cohort was 21.0 months, cancer-specific mortality cohort was 15.0 months. Organ-specific metastases were independently associated with survival prognosis.Conclusions. Nomogram score in estimating the long-term prognosis is feasible, for which contribute to directing clinical treatment and prognosis assessment in patient harboring site-distant metastases.