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Long-term survival for patients with ovarian cancer higher than expected
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Nearly one-third of women with epithelial ovarian cancer survived at least a decade after diagnosis, according to an analysis of data from the California Cancer Registry.
Researchers even observed long-term survival among women with high-risk disease, as well as those who did not demonstrate previously established characteristics associated with good outcomes.
“The perception that almost all women will die of this disease is not correct,” Rosemary D. Cress, MPH, PhD, an epidemiologist and associate adjunct professor in the department of public health sciences at University of California, Davis, said in a press release. “This information will be helpful to physicians who first diagnose these patients and the obstetricians/gynecologists who take care of them after they receive treatment from specialists.”
Cress and colleagues used the California Cancer Registry to identify 11,541 women diagnosed with epithelial ovarian cancer between 1994 and 2001.
Because most studies of this population assess 5-year survival, Cress and colleagues wanted to evaluate 10-year trajectories for these patients to try to identify characteristics associated with long-term survival.
About one-third (31%; 95% CI, 30.2-31.8) of the women analyzed survived more than 10 years. The majority of those women met criteria that prior studies showed are associated with long-term survival, including younger age, earlier disease stage and lower-grade tumors at diagnosis. However, about one-quarter (26.6%) of the women who survived at least 10 years were considered high-risk patients due to older age at diagnosis, or advanced tumor stage or grade.
The majority of the 10-year survivors had stage I cancer; however, 32.4% (95% CI, 30.9-33.9) had stage III or stage IV disease at diagnosis.
“This information is important for patient counselling,” Gary S. Leiserowitz MD, professor of gynecologic oncology and interim chair of the department of obstetrics and gynecology at UC Davis, said in the release. “Many patients and physicians know that ovarian cancer is a dangerous cancer, but they don’t realize that there is significant biological variability among patients. It’s not a uniformly fatal prognosis.”
Gary S. Leiserowitz
Future studies are necessary to determine why such a high percentage of women survived so long despite their pathology.
One theory may be that women who have BRCA1 or BRCA2 mutations respond better to chemotherapy than women who do not have those mutations, Leiserowitz said. Other biological factors and superior efficacy of certain treatments also may contribute.
“This is an exploratory study to figure out who has survived,” Leiserowitz said. “We can now go back and look at tumor tissue to do a comparison between long- and short-term survivors to see if there is a genetic basis for that.” – by Anthony SanFilippo
Disclosure: The researchers report no relevant financial disclosures.
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