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Long-term survival outcome of advanced epithelial ovarian cancer: A single institutional study
Patel Viral1, Anupama Rajanbabu1, Keechilat Pavithran2, K Chithrathara3, Indu R Nair4, Renjitha Bhaskaran5, Paleth Gangadharan6, DK Vijaykumar1
1 Department of Gynecological Oncology, Amrita Institute of Medical Science, Kochi, Kerala, India
2 Department of Medical Oncology, Amrita Institute of Medical Science, Kochi, Kerala, India
3 Department of Gynecological Oncology, VPS Lakeshore hospital, Kochi, Kerala, India
4 Department of Pathology, Amrita Institute of Medical Science, Kochi, Kerala, India
5 Department of Biostatistics, Amrita Institute of Medical Science, Kochi, Kerala, India
6 Department of Cancer Registry, Amrita Institute of Medical Science, Kochi, Kerala, India
Background: A number of patients with advanced-stage epithelial ovarian cancer do survive beyond 5 years. The long-term follow-up data are limited, especially for the Indian setting. We evaluated the 10-year survival outcome and influencing clinicopathological factors.
Methods: A retrospective analysis of advanced-stage epithelial ovarian cancer patients who underwent primary cytoreductive surgery (PCS) or interval cytoreductive surgery (ICS) from 2005 to 2008 was conducted. Survival analysis was performed with the Kaplan–Meier method, and the Cox proportional hazards model was used for prognostic clinicopathological factors analysis.
Results: Ninety-four patients with a median age of 54.5 (18–79) years were evaluated. The median follow-up period was 11.2 years. The overall survival (OS) rates at 5, 7, and 10 years were 37%, 23%, and 18%, respectively. The median OS (MOS) was 46 (95% confidence interval [CI], 36–55.8) months and progression-free survival (PFS) was 19.5 (15.3–23.6) months. Long-term survival was significantly predicted by R0 resection (complete cytoreduction with no macroscopic residual disease) and PFS >20 months while prolonged PFS was influenced by age ≤55 years and R0 resection. For the R0 resection group, patients who underwent PCS had better overall survival in comparison with ICS [72.1(25.2-119) months vs 47.4 (34.9–59.9)months] on 10 years follow-up but was not significant statistically.
Conclusion: Patients with age ≤55 years, R0 resection, PFS >20 months have a better 10-year survival outcome. Among R0 resection, patients undergoing PCS have clinically a better outcome on 10-year follow-up.
Department of Gynecological Oncology, Amrita Institute of Medical Science, Kochi, Kerala
Source of Support: None, Conflict of Interest: None