Analysis of prognostic factor and survival in patients with epithelial ovarian cancer treated with combination chemotherapy

Choi, Il Jung; Kwak, Bong Gyu; Han, Myoung Seok; Cha, Moon Seok; Kim, Hyun Ho; Je, Goo Hwa

Abstract

OBJECTIVE
The purpose of this retrospective study is to identify and to discuss the clinical relevance of prognostic factors and survival rate in patients with epithelial ovarian cancer treated with combination chemotherapy.
METHODS
A total of 98 histologically verified patients with epithelial ovarian cancer who were treated at Dong-A Medical Center between 1997 and 2002 were used for analysis. The 30 patients having borderline tumor were excluded. Kaplan-Meier survival curves were computed and tested statistically by the log rank test. A multivariable Cox proportional hazard model was applied to access the prognostic significance of the different covariates.
RESULTS
The median age of the patients with epithelial ovarian cancer was 46.6 years and FIGO stage distribution was 38.2% for stage I, 5.9% for stage II, 44.1% for stage III, 11.8% for stage IV. The histopathologic type distribution were serous type (45.6%), mucinous type (36.8%), endometriod type (8.8%), clear cell type (7.4%), mixed type (1.4%). Residual tumor volume size of less than 1 cm or 1 cm was identified in 50 patients (73.5%) and more than 1 cm in 18 patients (26.5%) after primary cytoreductive surgery. The overall 5-year survival rate was 55.7%. According to univariate analysis, FIGO stage (p<0.0001), residual volume (p<0.0001), ascitic fluid volume (p=0.0001), menopause (p=0.0021), CA125 (p=0.0058), tumor size (p=0.0099), age (p=0.0113) were significant prognostic factors affecting survival. However, multivariate analysis in this study demonstrated that FIGO stage (p=0.011), residual tumor volume (p=0.026), ascitic fluid volume (p=0.031) were found to be the most significant independent prognostic factors.
CONCLUSION
In this retrospective study, the overall 5-year survival rate of patients with epithelial ovarian cancer treated with combination chemotherapy was 55.7% and 5-year survival rate of stage I/II was 95.8%, stage III 28.4%, stage IV 0%. The overall survival of stage I/II were 90 months, stage III 39 months, stage IV 17 months. In multiple analysis, FIGO stage, residual volume, ascitic fluid volume were identified as three most significant independent prognostic factors.