Survival and Impact of Tumor Grade, Residual Disease and Age in Patients Suffering From Epithelial Ovarian Cancer

Abstract

Objective: To determine the overall survival and impact of histopathological grade, residual
disease and age on survival of patients with epithelial ovarian cancer.
Study Design: Retrospective study.
Place and Duration of study: Department of Medical Oncology, Jinnah Hospital Lahore, from
Jan 01, 2001 to Dec 31, 2002.
Patients & Methods: Patients with all stages of epithelial ovarian cancer with histological
documentation of the disease were included in the study. Patients with malignant ascites
consistent with adenocarcinoma with an ovarian mass were also included. Patients with germ cell
or stromal tumors were excluded. Patients with ovarian metastases from any other malignancy
were also excluded. Survival from the date of diagnosis was the end point. Overall survival was
calculated from the date of diagnosis to the date of death or the date when the patient was last
known to be alive. The impact of age of the patient (< 50 yrs vs ≥ 50 yrs.), tumor grade ( low grade
vs. intermediate and high grade) and residual disease ( <1.5 cm vs. >1.5 cm) on survival was
evaluated. Information was collected from medical records and a thorough review was done. The
data was analyzed by SPSS. Survival was evaluated by the Kaplan- Meier Survival plot.
Results: Seventy-five patients were accrued to the study. Median age of the patients was 47
years. Mean overall survival was 36 months (95% C.I, 26 to 47). Overall 5-year survival rate was
38%.Younger age at presentation, high tumor grade and bulky residual disease are poor
prognostic factors, having an adverse affect on survival in epithelial ovarian cancer. Patients with
well-differentiated tumors had a mean survival of 44 months as compared to just 17 months for
patients with moderate to poorly differentiated tumors (p=.002). Patients with minimal residual
disease after initial surgery had a mean survival of 52 months whereas those with bulky disease
had a survival of 13 months only (p=.000). The overall survival of patients younger than 50 years
was 29 months and those older than 50 years was 39 months.
Conclusion: Younger age at diagnosis, high histological grade and suboptimal debulking are
associated with inferior survival in patients with epithelial ovarian cancer.