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 and 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] 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 effect 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