Ovarian Cancer: Post-Relapse Survival and Prognostic Factors

Ai Miyoshi, Serika Kanao, Hirokazu Naoi, Hirofumi Otsuka, Takeshi Yokoi

Abstract


Background: Patients with relapsing ovarian cancer have a particularly poor prognosis, it is thus important for oncology consultants to anticipate the patient’s adverse prognosis and to select an optimum treatment plan. We report here our retrospective review of the treatment outcomes of the post-relapse survival (PRS) for ovarian cancer and the different prognostic factors for relapsing patients.

Methods: Totally 242 patients with ovarian cancer were admitted to our institution. All underwent surgery, and all achieved complete remission of their primary disease. Of the 242 patients, 48 were subsequently diagnosed with a recurrence. We retrospectively reviewed their initial FIGO staging, the histology of their tumors, the treatment-free interval (TFI), the number of recurrent lesions, the treatment for the recurrence (whether treatment included surgery, radiotherapy or chemotherapy), and the number of chemotherapy regimens applied for treatment of the recurrence.

Results: The median age of the 48 relapse patients was 59 years (range 34 - 83); the median follow-up period was 40 months (range 4 - 103). The multivariate Cox proportional hazards model demonstrated that having a mucinous histology (P = 0.029), having a TFI of less than 6 months (P = 0.0002), having a solitary recurrent lesion (P = 0.011), and no chemotherapy (P = 0.007) were independent risk factors associated with PRS. The number of recurrent lesions, multimodal treatment for recurrence, the number of chemotherapy regimens used for treatment, and use of bevacizumab were not independent factors for PRS.

Conclusions: In regards to recurrent ovarian cancer, after achieving complete surgical remission of the primary disease, having a mucinous adenocarcinoma histology and/or a TFI of less than 6 months worsened the prognosis for the patient. Having a solitary recurrent lesion was a better prognostic factor regardless of whether or not they received surgical treatment. Chemotherapy could improve PRS, if the performance status (PS) of the patient allows her to receive chemotherapy, and if she is desirous of the attempt to extend her life.




J Clin Gynecol Obstet. 2018;7(2):31-36
doi: https://doi.org/10.14740/jcgo488w


Keywords


Post-relapse survival; Ovarian cancer; Prognostic factor

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