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Impact of Prognostic Factors on Survival Rates in Patients with Ovarian Carcinoma

  • Arikan, Sevim Kalsen (Obstetrics and Gynecology, Ataturk Training and Research Hospital) ;
  • Kasap, Burcu (Obstetrics and Gynecology, Faculty of Medicine, Mugla Sitki Kocman University) ;
  • Yetimalar, Hakan (Obstetrics and Gynecology, Ataturk Training and Research Hospital) ;
  • Yildiz, Askin (Obstetrics and Gynecology, Ataturk Training and Research Hospital) ;
  • Sakarya, Derya Kilic (Obstetrics and Gynecology, Ataturk Training and Research Hospital) ;
  • Tatar, Sumeyra (Obstetrics and Gynecology, Faculty of Medicine, Sifa University)
  • Published : 2014.08.15

Abstract

Purpose: The aim of the present study was to invesitigate the impact of significant clinico-pathological prognostic factors on survival rates and to identify factors predictive of poor outcome in patients with ovarian carcinoma. Materials and Methods: A retrospective chart review of 74 women with pathologically proven ovarian carcinoma who were treated between January 2006 and April 2011 was performed. Patients were investigated with respect to survival to find the possible effects of age, gravida, parity, menstruel condition, pre-operative Ca-125, treatment period, cytologic washings, presence of ascites, tumor histology, stage and grade, maximal tumor diameter, adjuvan chemotherapy and cytoreductive success. Also 55 ovarian carcinoma patients were investigated with respect to prognostic factors for early 2-year survival. Results: The two-year survival rate was 69% and the 5-year survival rate was 25.5% for the whole study population. Significant factors for 2-year survival were preoperative CA-125 level, malignant cytology and FIGO clinical stage. Significant factors for 5-year survival were age, preoperative CA-125 level, residual tumor, lymph node metastases, histologic type of tumor, malignant cytology and FIGO clinical stage. Logistic regression revealed that independent prognostic factors of 5-year survival were patient age, lymph node metastasis and malignant cytology. Conclusions: We consider quality registries with prospectively collected data to be one important tool in monitoring treatment effects in population-based cancer research.

Keywords

References

  1. Abe A, Furumoto H, Irahara M, et al (2010). The impact of systematic para-aortic and pelvic lymphadenectomy on survival in patients with optimally debulked ovarian cancer. J Obstet Gynaecol Res, 36, 1023-30. https://doi.org/10.1111/j.1447-0756.2010.01274.x
  2. Bosze P, Bast RC, Berchuck A, et al (2000). Conseusus statements on prognostic factors in epithelial ovarian carcinoma. report of the consensus meeting organized by the european society of gynaecological oncology, ESGO. Eur J Gynaecol Oncol, 21, 513-26.
  3. Braem MG, Onland-Moret NC, van den Brandt PA, et al (2010). Reproductive and hormonal factors in association with ovarian cancer in the Netherlands cohort study. Am J Epidemiol, 172, 1181-9. https://doi.org/10.1093/aje/kwq264
  4. Bristow RE, Tomacruz RS, Armstrong DK, Trimble EL, Montz FJ (2002). Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a meta-analysis. J Clin Oncol, 20, 1248-59. https://doi.org/10.1200/JCO.20.5.1248
  5. Chan JK, Loizzi V, Lin YG, et al (2003). Stages III and IV invasive epithelial ovarian carcinoma in younger versus older women: what prognostic factors are important? Obstet Gynecol, 102, 156-61. https://doi.org/10.1016/S0029-7844(03)00399-5
  6. Chan JK, Cheung MK, Husain A, et al (2006). Patterns and progress in ovarian cancer over 14 years. Obstet Gynecol, 108, 521-8. https://doi.org/10.1097/01.AOG.0000231680.58221.a7
  7. Chan JK, Loizzi V, Lin YG, et al (2006). Ovarian cancer in younger vs older women: a population-based analysis. Br J Cancer, 95, 1314-20. https://doi.org/10.1038/sj.bjc.6603457
  8. Chi DS, Eisenhauer EL, Lang J, et al (2006). What is the optimal goal of primary cytoreductive surgery for bulky stage IIIC epithelial ovarian carcinoma (EOC)? Gynecol Oncol, 103, 559-64. https://doi.org/10.1016/j.ygyno.2006.03.051
  9. Clark TG, Stewart ME, Altman DG, Gabra H, Smyth JF (2001). A prognostic model for ovarian cancer. Br J Cancer, 85, 944-52. https://doi.org/10.1054/bjoc.2001.2030
  10. Cooper BC, Sood AK, Davis CS, et al (2002). Preoperative CA 125 levels: an independent prognostic factor for epithelial ovarian cancer. Obstet Gynecol, 100, 59-64. https://doi.org/10.1016/S0029-7844(02)02057-4
  11. Coussy F, Chereau E, Darai E, et al (2011). Interest of CA 125 level in management of ovarian cancer. Gynecol Obstet Fertil, 39, 296-301. https://doi.org/10.1016/j.gyobfe.2010.10.018
  12. Creasman WT, Rutledge F (1971). The prognostic value of peritoneal cytology in gynecologic malignant disease. Am J Obstet Gynecol, 110, 773-81.
  13. Du Bois A, Reuss A, Pujade-Lauraine E, et al (2009). Role of surgical outcome as prognostic factor in advanced epithelial ovarian cancer: a combined exploratory analysis of 3 prospectively randomized phase 3 multicenter trials: by the Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom (AGO-OVAR) and the Groupe d'Investigateurs Nationaux Pour les Etudes des Cancers de l'Ovaire (GINECO). Cancer, 115, 1234-44. https://doi.org/10.1002/cncr.24149
  14. Du Bois A, Rochon J, Lamparter C, Pfisterer J; AGO Organkommission OVAR PFisterer (2005). Pattern of care and impact of participation in clinical studies on the outcome in ovarian cancer. Int J Gynecol Cancer, 15, 183-91. https://doi.org/10.1111/j.1525-1438.2005.15202.x
  15. Duffy MJ, Bonfrer JM, Kulpa J, et al (2005). CA125 in ovarian cancer: European group on tumor markers guidelines for clinical use. Int J Gynecol Cancer, 15, 679-91. https://doi.org/10.1111/j.1525-1438.2005.00130.x
  16. Eisenkop SM, Spirtos NM, Friedman RL, et al (2003). Relative influences of tumor volume before surgery and the cytoreductive outcome on survival for patients with advanced ovarian cancer: a prospective study. Gynecol Oncol, 90, 390-6. https://doi.org/10.1016/S0090-8258(03)00278-6
  17. Gaemmaghami F, Yousefi Z, Gilani M, Mosavi A, Shariat M (2011). Role of appropriate surgery in survival of patients with epithelial ovarian cancer. Asian Pac J Cancer Prev, 12, 253-7.
  18. Gerestein CG, Eijkemans MJ, de Jong D, et al (2009). The prediction of progression-free and overall survival in women with an advanced stage of epithelial ovarian carcinoma. BJOG, 116, 372-80. https://doi.org/10.1111/j.1471-0528.2008.02033.x
  19. Gertig D, Hunter D (2002). Ovarian cancer. In: Adami H, Hunter D, Trichopoulos D, eds. Textbook of cancer epidemiology. Oxford: Oxford University Press, 378-99.
  20. Griffiths CT (1975). Surgical resection of tumor bulk in the primary treatment of ovarian carcinoma. Natl Cancer Inst Monogr, 42, 101-4.
  21. Gungor T, Kanat-Pektas M, Sucak A, Mollamahmutoglu L (2009). The role of thrombocytosis in prognostic evaluation of epithelial ovarian tumors. Arch Gynecol Obstet, 279, 53-6. https://doi.org/10.1007/s00404-008-0673-9
  22. Heintz AP, Odicino F, Maisonneuve P, et al (2006). Carcinoma of the ovary. FIGO 26th annual report on the results of treatment in gynecological cancer. Int J Gynaecol Obstet, 95, 161-92. https://doi.org/10.1016/j.ijgo.2006.05.005
  23. Hogberg T, Carstensen J, Simonsen E (1993). Treatment results and prognostic factors in a population-based study of epithelial ovarian cancer. Gynecol Oncol, 48, 38-49. https://doi.org/10.1006/gyno.1993.1007
  24. Hoskins WJ, McGuire WP, Brady MF, et al (1994). The effect of diameter of largest residual disease on survival after primary cytoreductive surgery in patients with suboptimal residual epithelial ovarian carcinoma. Am J Obstet Gynecol, 170, 974-9. https://doi.org/10.1016/S0002-9378(94)70090-7
  25. International Federation of Gynecology and Obstetrics (FIGO) (1987). Changes in definition of clinical staging for carcinoma of the cervix and ovary. Am J Obstet Gynecol, 56, 263-4.
  26. Keettel WC, Pixley E (1958). Diagnostic value of peritoneal washings. Clin Obstet Gynecol, 1, 592-606. https://doi.org/10.1097/00003081-195809000-00005
  27. Li AJ, Madden AC, Cass I, et al (2004). The prognostic significance of thrombocytosis in epithelial ovarian carcinoma. Gynecol Oncol, 92, 211-4. https://doi.org/10.1016/j.ygyno.2003.09.002
  28. Li LN, Zhou X, Gu Y, Yan J (2013). Prognostic value of MMP-9 in ovarian cancer: a meta-analysis. Asian Pac J Cancer Prev, 14, 4107-13. https://doi.org/10.7314/APJCP.2013.14.7.4107
  29. Liu XH, Man YN, Wu XZ (2014). Recurrence season impacts the survival of epithelial ovarian cancer patients. Asian Pac J Cancer Prev, 15, 1627-32. https://doi.org/10.7314/APJCP.2014.15.4.1627
  30. Makar AP, Baekelandt M, Trope CG, Kristensen GB (1995). The prognostic significance of residual disease, FIGO substage, tumor histology, and grade in patients with FIGO stage III ovarian cancer. Gynecol Oncol, 56, 175-80. https://doi.org/10.1006/gyno.1995.1027
  31. Matei MC, Caruntu ID, Negura L, et al (2010). The assessment of relations between main histologic type of ovarian cancer and some risk and prognostic factors. Rev Med Chir Soc Med Nat Iasi, 114, 1135-41.
  32. Meyer T, Rustin GJ (2000). Role of tumour markers in monitoring epithelial ovarian cancer. Br J Cancer, 82, 1535-8. https://doi.org/10.1054/bjoc.2000.1174
  33. Mizuno M, Kikkawa F, Shibata K, et al (2003). Long-term prognosis of stage I ovarian carcinoma. Prognostic importance of intraoperative rupture. Oncology, 65, 29-36.
  34. Moore DH, Kauderer JT, Bell J, Curtin JP, Van Le L (2004). An assessment of age and other factors influencing protocol versus alternative treatments for patients with epithelial ovarian cancer referred to member institutions: a gynecologic oncology group study. Gynecol Oncol, 94, 368-74. https://doi.org/10.1016/j.ygyno.2004.05.033
  35. Morton DG, Moore JG, Chang N (1961). The clinical value of peritoneal lavage for cytologic examination. Am J Obstet Gynecol, 81, 1115-25.
  36. Panici PB, Maggioni A, Hacker N, et al (2005). Systematic aortic and pelvic lymphadenectomy versus resection of bulky nodes only in optimally debulked advanced ovarian cancer: a randomized clinical trial. J Natl Cancer Inst, 97, 560-6. https://doi.org/10.1093/jnci/dji102
  37. Riman T, Persson I, Nilsson S (1998). Hormonal aspects of epithelial ovarian cancer: review of epidemiological evidence. Clin Endocrinol, 49, 695-707. https://doi.org/10.1046/j.1365-2265.1998.00577.x
  38. Riman T, Nilsson S, Persson IR (2004). Review of epidemiological evidence for reproductive and hormonal factors in relation to the risk of epithelial ovarian malignancies. Acta Obstet Gynecol Scand, 83, 783-95. https://doi.org/10.1080/j.0001-6349.2004.00550.x
  39. Salet-Lizee D, Alsary S (2008). (The place of lumo-aortic and pelvic lymph node dissection in the treatment of ovarian cancer). J Chir (Paris), 145, 45-49.
  40. Salzman J, Marinelli RJ, Wang PL, et al (2011). ESRRAC11orf20 is a recurrent gene fusion in serous ovarian carcinoma. PLoS Biol, 9, 1001156. https://doi.org/10.1371/journal.pbio.1001156
  41. Sankaranarayanan R, Ferlay J (2006). Worldwide burden of gynaecological cancer: the size of the problem. Best Pract Res Clin Obstet Gynaecol, 20, 207-25. https://doi.org/10.1016/j.bpobgyn.2005.10.007
  42. Tang L, Zheng M, Xiong Y, Ding H, Liu FY (2008). Clinical characteristics and prognosis of epithelial ovarian cancer in young women. Ai Zheng, 27, 951-5.
  43. Tingulstad S, Skjeldestad FE, Halvorsen TB, Hagen B (2003). Survival and prognostic factors in patients with ovarian cancer. Obstet Gynecol, 101, 885-91. https://doi.org/10.1016/S0029-7844(03)00123-6
  44. Vergote I, De Brabanter J, Fyles A, et al (2001). Prognostic importance of degree of differentiation and cyst rupture in stage I invasive epithelial ovarian carcinoma. Lancet, 357, 176-182. https://doi.org/10.1016/S0140-6736(00)03590-X
  45. Wan WN, Zhang YX, Wang XM, et al (2014). ATAD2 is highly expressed in ovarian carcinomas and indicates poor prognosis. Asian Pac J Cancer Prev, 15, 2777-83 https://doi.org/10.7314/APJCP.2014.15.6.2777
  46. Zuna RE, Behrens A (1996). Peritoneal washing cytology in gynecologic cancers: long-term follow-up of 355 patients. J Natl Cancer Inst, 88, 980-7. https://doi.org/10.1093/jnci/88.14.980

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