Please wait a minute...
Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front Med    2014, Vol. 8 Issue (1) : 91-95    https://doi.org/10.1007/s11684-014-0305-7
RESEARCH ARTICLE
Clinical outcomes and prognostic factors of patients with epithelial ovarian cancer subjected to first-line treatment: a retrospective study of 251 cases
Yunfeng Fu1, Xinyu Wang1, Zimin Pan1, Xing Xie1,2()
1. Department of Gynecologic Oncology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China; 2. Women’s Reproduction and Health Laboratory of Zhejiang Province, Hangzhou 310006, China
 Download: PDF(89 KB)   HTML
 Export: BibTeX | EndNote | Reference Manager | ProCite | RefWorks
Abstract

A total of 251 patients with epithelial ovarian cancer (EOC) treated between 2002 and 2008 was retrospectively analyzed to investigate the long-term outcomes and prognostic factors of these patients, particularly those who underwent primary debulking surgery followed by platinum-based chemotherapy. Clinico-pathological parameters, including progression-free survival (PFS) and overall survival (OS), were also analyzed. The median follow-up period from the end of initial treatment to June 2010 was 58 months. The three-year PFS rate was 61.7% for International Federation of Gynecology and Obstetrics (FIGO) I–II, 19.9% for FIGO III–IV, and 33.9% for all stages. By comparison, the five-year PFS rate was 44.6% for FIGO I–II, 17.7% for FIGO III–IV, and 28.3% for all stages. The three-year OS rate was 67.9% for FIGO I–II, 41.7% for FIGO III–IV, and 50.2% for all stages. The five-year OS rate was 52.7% for FIGO I–II, 30.8% for FIGO III–IV, and 39.2% for all stages. Univariate analysis revealed that advanced FIGO stage, serum CA125, and suboptimal debulking were significant factors affecting PFS and OS. In multivariate analysis, PFS was significantly influenced by FIGO stage and suboptimal debulking. However, OS was significantly influenced by advanced FIGO stage only. Our study confirms the efficacy of surgery followed by platinum-based chemotherapy for EOC. FIGO stage is considered as one of the most reliable predictors of the prognosis of patients with EOC.

Keywords ovarian carcinoma      prognostic factors      surgery      chemotherapy      survival     
Corresponding Author(s): Xie Xing,Email:xiex@zju.edu.cn   
Issue Date: 26 April 2014
 Cite this article:   
Yunfeng Fu,Xinyu Wang,Zimin Pan, et al. Clinical outcomes and prognostic factors of patients with epithelial ovarian cancer subjected to first-line treatment: a retrospective study of 251 cases[J]. Front Med, 2014, 8(1): 91-95.
 URL:  
https://academic.hep.com.cn/fmd/EN/10.1007/s11684-014-0305-7
https://academic.hep.com.cn/fmd/EN/Y2014/V8/I1/91
CharacteristicsNo. of patients
Age
≤50117 (46.6%)
>50134 (53.4%)
FIGO stage
Stage I50 (19.9%)
Stage II38 (15.1%)
Stage III147 (58.6%)
Stage IV16 (6.4%)
Histological type
Serous117 (46.6%)
Non-serous134 (53.4%)
Histological grade
Grade 120 (8.0%)
Grade 251 (20.3%)
Grade 3157 (62.5%)
Not defined23 (9.2%)
Extent of surgery
Optimal surgery187 (74.5%)
Suboptimal surgery64 (25.5%)
Tab.1  Clinical and histopathological characteristics of the 251 patients with epithelial ovarian cancer
ParametersUnivariateMultivariate
HR 95% CI P valueHR95% CIP value
Age (year)
≤50ReferenceReference
> 501.4100.922-2.1570.1131.8001.009-3.2100.074
FIGO stage
I/ IIReferenceReference
III/ IV9.011 4.155-19.541 0.0004.1451.569-10.9530.004
Histology
SerousReferenceReference
Non-serous0.7560.501-1.1410.7561.1210.637-1.9710.693
Grade
G1ReferenceReference
G21.6890.568-5.0220.3460.4770.125-1.8260.280
G32.3140.842-6.3580.1040.5330.154-1.840.320
Tumor size (cm)
≤10ReferenceReference
>100.9640.615-1.5120.8740.9570.494-1.8530.896
CA125 (U/L)
≤500ReferenceReference
>5002.7821.725-4.878 0.0000.8750.512-1.8970.578
Debulking
OptimalReferenceReference
Suboptimal5.1923.364-80120.0002.3711.221-4.6060.011
Tab.2  Univariate and multivariate analyses of factors associated with progression-free survival using Cox proportional hazard model
ParametersUnivariateMultivariate
HR95% CIP valueHR95% CI P value
Age (year)
≤50ReferenceReference
> 501.4520.965-2.1850.0731.6240.944-2.7910.080
FIGO stage
I/ IIReferenceReference
III/ IV8.6424.005-18.6500.0003.4481.303-9.123 0.013
Histology
SerousReferenceReference
Non-serous0.7400.497-1.1010.7560.8320.479-1.4460.515
Grade
G1ReferenceReference
G21.6160.602-4.3380.3410.6970.187-2.6050.592
G32.2660.913-5.6240.0780.8140.237-2.7890.743
Tumor size (cm)
≤10ReferenceReference
>100.9520.617-1.4690.8240.8490.458-1.5750.604
CA125 (U/L)
≤500ReferenceReference
>5003.0081.856-5.0970.0001.5910.960-2.5890.092
Debulking
OptimalReferenceReference
Suboptimal3.7212.486-5.5710.0001.5860.863-1.5750.137
Tab.3  Univariate and multivariate analyses of factors associated with overall survival using Cox proportional hazard model
1 Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin 2012; 62(1): 10-29
doi: 10.3322/caac.20138 pmid:22237781
2 Benedet JL, Bender H, Jones H 3rd, Ngan HY, Pecorelli S. FIGO staging classifications and clinical practice guidelines in the management of gynecologic cancers. Int J Gynaecol Obstet 2000; 70(2): 209-262
doi: 10.1016/S0020-7292(00)90001-8 pmid:11041682
3 Morgan RJ Jr, Alvarez RD, Armstrong DK, Burger RA, Castells M, Chen LM, Copeland L, Crispens MA, Gershenson D, Gray H, Hakam A, Havrilesky LJ, Johnston C, Lele S, Martin L, Matulonis UA, O'Malley DM, Penson RT, Remmenga SW, Sabbatini P, Santoso JT, Schilder RJ, Schink J, Teng N, Werner TL, Hughes M, Dwyer MA; National Comprehensive Cancer Network. Ovarian cancer, version 3.2012. J Natl Compr Canc Netw 2012;10(11):1339–49
pmid:23138163
4 Hennessy BT, Coleman RL, Markman M. Ovarian cancer. Lancet 2009; 374(9698): 1371-1382
doi: 10.1016/S0140-6736(09)61338-6 pmid:19793610
5 Jelovac D, Armstrong DK. Recent progress in the diagnosis and treatment of ovarian cancer. CA Cancer J Clin 2011; 61(3): 183-203
doi: 10.3322/caac.20113 pmid:21521830
6 International Collaborative Ovarian Neoplasm Group. Paclitaxel plus carboplatin versus standard chemotherapy with either single-agent carboplatin or cyclophosphamide, doxorubicin, and cisplatin in women with ovarian cancer: the ICON3 randomised trial. Lancet 2002; 360(9332): 505-515
doi: 10.1016/S0140-6736(02)09738-6 pmid:12241653
7 Muggia FM, Braly PS, Brady MF, Sutton G, Niemann TH, Lentz SL, Alvarez RD, Kucera PR, Small JM. Phase III randomized study of cisplatin versus paclitaxel versus cisplatin and paclitaxel in patients with suboptimal stage III or IV ovarian cancer: a gynecologic oncology group study. J Clin Oncol 2000; 18(1): 106-115
pmid:10623700
8 Husseinzadeh N. Status of tumor markers in epithelial ovarian cancer has there been any progress? A review. Gynecol Oncol 2011; 120(1): 152-157
doi: 10.1016/j.ygyno.2010.09.002 pmid:20934205
9 Bristow RE, Tomacruz RS, Armstrong DK, Trimble EL, Montz FJ. Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a meta-analysis. J Clin Oncol 2002; 20(5): 1248-1259
doi: 10.1200/JCO.20.5.1248 pmid:11870167
[1] Wei Tian, Bo Liu, Da He, Yajun Liu, Xiaoguang Han, Jingwei Zhao, Mingxing Fan, International Society for Computer Assisted Orthopaedic Surgery. Guidelines for navigation-assisted spine surgery[J]. Front. Med., 2020, 14(4): 518-527.
[2] Yuyang Chen, Shu’an Zhang, Zhonghao Wu, Bo Yang, Qingquan Luo, Kai Xu. Review of surgical robotic systems for keyhole and endoscopic procedures: state of the art and perspectives[J]. Front. Med., 2020, 14(4): 382-403.
[3] Allison J. Navarrete-Welton, Daniel A. Hashimoto. Current applications of artificial intelligence for intraoperative decision support in surgery[J]. Front. Med., 2020, 14(4): 369-381.
[4] Bowen Jiang, Tej D. Azad, Ethan Cottrill, Corinna C. Zygourakis, Alex M. Zhu, Neil Crawford, Nicholas Theodore. New spinal robotic technologies[J]. Front. Med., 2019, 13(6): 723-729.
[5] Ling Wang, Ying Wang, Jiong Hu, Yuqian Sun, He Huang, Jing Chen, Jianyong Li, Jun Ma, Juan Li, Yingmin Liang, Jianmin Wang, Yan Li, Kang Yu, Jianda Hu, Jie Jin, Chun Wang, Depei Wu, Yang Xiao, Xiaojun Huang. Clinical risk score for invasive fungal diseases in patients with hematological malignancies undergoing chemotherapy: China Assessment of Antifungal Therapy in Hematological Diseases (CAESAR) study[J]. Front. Med., 2019, 13(3): 365-377.
[6] Cynthia Rajani, Wei Jia. Bile acids and their effects on diabetes[J]. Front. Med., 2018, 12(6): 608-623.
[7] Bin Yang, Yan Yu, Jing Chen, Yan Zhang, Ye Yin, Nan Yu, Ge Chen, Shifei Zhu, Haiyan Huang, Yongqun Yuan, Jihui Ai, Xinyu Wang, Kezhen Li. Possibility of women treated with fertility-sparing surgery for non-epithelial ovarian tumors to safely and successfully become pregnant---a Chinese retrospective cohort study among 148 cases[J]. Front. Med., 2018, 12(5): 509-517.
[8] Qing Pang, Hao Jin, Zhongran Man, Yong Wang, Song Yang, Zongkuang Li, Yimin Lu, Huichun Liu, Lei Zhou. Radical versus conservative surgical treatment of liver hydatid cysts: a meta-analysis[J]. Front. Med., 2018, 12(3): 350-359.
[9] Yutao Liu, Yaxia Di, Shuai Fu. Risk factors for ventilator-associated pneumonia among patients undergoing major oncological surgery for head and neck cancer[J]. Front. Med., 2017, 11(2): 239-246.
[10] Xinsen Xu,Kai Qu,Qing Pang,Zhixin Wang,Yanyan Zhou,Chang Liu. Association between telomere length and survival in cancer patients: a meta-analysis and review of literature[J]. Front. Med., 2016, 10(2): 191-203.
[11] Lan Wang,Jueheng Wu,Jie Yuan,Xun Zhu,Hongmei Wu,Mengfeng Li. Midline2 is overexpressed and a prognostic indicator in human breast cancer and promotes breast cancer cell proliferation in vitro and in vivo[J]. Front. Med., 2016, 10(1): 41-51.
[12] Wen Xue,Yan Sheng,Xiangqin Weng,Yongmei Zhu,Yan Zhao,Pengpeng Xu,Xiaochun Fei,Xiaoyan Chen,Li Wang,Weili Zhao. Clinical characteristics and prognostic factors of patients with mature T-cell lymphoid malignancies: a single-institution study of 225 cases[J]. Front. Med., 2015, 9(4): 468-477.
[13] Eric C. H. Lai,Chung Ngai Tang. Robotic distal pancreatectomy versus conventional laparoscopic distal pancreatectomy: a comparative study for short-term outcomes[J]. Front. Med., 2015, 9(3): 356-360.
[14] Rui Zhu,Lin Shen,Caoyuan Wang,Yanping Yang,Rui Chen,Hen Fang,Xiaojuan Xu. A new minimally invasive treatment for anal fistula[J]. Front. Med., 2015, 9(1): 77-81.
[15] Shu Zhang, Yinwei Li, Xianqun Fan. Application of endoscopic techniques in orbital blowout fractures[J]. Front Med, 2013, 7(3): 328-332.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed