An Analysis of Clinicopathologic Prognostic Factors affecting Survival in Patients with Epithelial Ovarian Cancer / 대한산부인과학회잡지

ABSTRACT

OBJECTIVE: In this retrospective study, we analyzed the clinicopathologic characteristics of epithelial ovarian cancer and evluated the prognostic factors which has an impact on survival of the patients with epithelial ovarian cancer. Patients and METHODS: Total 147 patients with epithelial ovarian cancer who were treated at Samsung Medical Center between 1995 and 2000 were included. Medical records including pathologic reports were reviewed to identify clinicopathologic characteristics. Survival was analyzed by Kaplan-Meier method and log-rank test was used for curve comparison. Cox proportional hazards model was used for multivariate analysis. RESULTS: The histopathologic distribution of all the patients was as follows serous type (57.1%), mucinous type (15.0%), endometrioid type (15.0%), clear cell type (9.5%). mixed type (3.4%). The FIGO stage distribution for invasive epithelial ovarian cancer was stage I (29.3%), stage II (4.1%), stage III (54.4%), and stage IV (12.2%). The mean value of pre-operative CA-125 according to histologic type was 2715 IU/ml (S.E. 637) for serous type, 2002 IU/ml (S.E. 687) for endometrioid type, 896 IU/ml (S.E. 290) for mixed type, 421 IU/ml (S.E. 145) for mucinous type, and 236 IU/ml (S.E. 140) for clear cell ovarian cancer. No residual tumor was identified in 67 patients (48.9%) after primary cytoreductive surgery. Sixteen patients (11.7%) exhibited less than 2 cm tumor and 54 patients (39.4%) 2 cm or more macroscopic residual tumor. Second-look laparotomy was undertaken and pathologic residual disease was observed in 12 cases out of 39 (30.7%) patients. The overall 5-year survival rate of all the patients was 46.7%. In univariate analysis, FIGO stage (p=0.0091), grade (p=0.0081), residual volume (p=0.0038) and histologic type (p=0.0313) were significant prognostic factors affecting survival. However, multivariate analysis demonstrated that only FIGO stage (p=0.0048) was identified as a significant independent prognostic factor in this study. CONCLUSION: This study showed that FIGO stage was identified as a significant independent prognostic factor in the patients with epithelial ovarian cancer of all stages.