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Comparative Study
. 2017 Mar;129(3):439-447.
doi: 10.1097/AOG.0000000000001867.

Outcomes of Women With High-Grade and Low-Grade Advanced-Stage Serous Epithelial Ovarian Cancer

Allison Gockley  1 , Alexander Melamed, Amy J Bregar, Joel T Clemmer, Michael Birrer, John O Schorge, Marcela G Del Carmen, J Alejandro Rauh-Hain
Affiliations
Comparative Study

Outcomes of Women With High-Grade and Low-Grade Advanced-Stage Serous Epithelial Ovarian Cancer

Allison Gockley et al. Obstet Gynecol. 2017 Mar.

Abstract

Objective: To compare outcomes of women with advanced-stage low-grade serous ovarian cancer and high-grade serous ovarian cancer and identify factors associated with survival among patients with advanced-stage low-grade serous ovarian cancer.

Methods: A retrospective study of patients diagnosed with grade 1 or 3, advanced-stage (stage IIIC and IV) serous ovarian cancer between 2003 and 2011 was undertaken using the National Cancer Database, a large administrative database. The effect of grade on survival was analyzed using the Kaplan-Meier method. Factors predictive of outcome were compared using the Cox proportional hazards model. Among women with low-grade serous ovarian cancer, propensity score matching was used to compare all-cause mortality among similar women who underwent chemotherapy and lymph node dissection and those who did not.

Results: A total of 16,854 (95.7%) patients with high-grade serous ovarian cancer and 755 (4.3%) patients with low-grade serous ovarian cancer were identified. Median overall survival was 40.7 months among high-grade patients and 90.8 months among women with low-grade tumors (P<.001). Among patients with low-grade serous ovarian cancer in the propensity score-matched cohort, the median overall survival was 88.2 months among the 140 patients who received chemotherapy and 95.9 months among the 140 who did not receive chemotherapy (P=.7). Conversely, in the lymph node dissection propensity-matched cohort, median overall survival was 106.5 months among the 202 patients who underwent lymph node dissection and 58 months among the 202 who did not (P<.001).

Conclusion: When compared with high-grade serous ovarian cancer, low-grade serous ovarian cancer is associated with improved survival. In patients with advanced-stage low-grade serous ovarian cancer, lymphadenectomy but not adjuvant chemotherapy was associated with improved survival.

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Conflict of interest statement

Financial Disclosure

The authors did not report any potential conflicts of interest.

Figures

Figure 1
Figure 1
Mortality for women diagnosed with stage IIIC low-grade and high-grade serous ovarian carcinoma.
Figure 2
Figure 2
Mortality for women diagnosed with stage IV low-grade and high-grade serous ovarian carcinoma.
See this image and copyright information in PMC

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