A retrospective study demonstrating improvement in 5-year and post-relapse survival in ovarian cancer patients over a 24-year period
Session type: Poster / e-Poster / Silent Theatre session
University of Edinburgh Cancer Research Centre, UK
Ovarian cancer is the fourth most common malignancy affecting women in the UK, accounting for 6% of female cancer deaths. However, ovarian cancer is not a homogenous disease; survival figures which consider it a single entity are misleading. A more accurate picture of survival trends can be produced by considering previously established independent prognostic indicators in analysis of survival data.
To establish how survival has changed over a 24 year period in ovarian cancer patients treated by a cancer network serving 1.25 million people.
Clinicopathological details of 2359 women diagnosed with ovarian malignancy between 01/01/1981 and 31/12/04 were extracted from a prospectively collected ovarian cancer database. Data were analysed by χ2 tests and the Kaplan-Meier method using SPSS 14.0 and GraphPad Prism 4.0.
1946 women with epithelial ovarian cancer were included in the analysis. 5-year survival increased from 30.21% to 33.31% (p=0.009). Subgroup analysis demonstrated variations in survival improvement depending on clinicopathological features. Clinically significant increases in 5-year survival were seen for patients with advanced stage serous (10.12% to 18.81%), endometrioid (17.63% to 27.52%) and clear-cell (3.20% to 17.43%, p<0.05) cancers. Patients who received partial debulking also had an improved 5-year survival (5.24% to 22.79%, p<0.001).
1210 patients were included in an analysis of relapsed disease. Survival at 3 years post-relapse increased (9.14% to 14.50%, p=0.003); most notably in late stage tumours (7.26% to 15.08%, p<0.001), and those with serous and endometrioid histology (9.62% to 15.39%, p=0.0025 and 15.39% to 23.90%, p=0.013).
5-year overall survival has increased, particularly in subgroups of patients with poor risk disease. Post-relapse survival has also increased. Preliminary analysis shows no change in the number of lines of chemotherapy received by patients; analysis of how changes in chemotherapy regimes relate to survival is ongoing.