Clinical characteristics and prognostic inflection points among long-term survivors of advanced epithelial ovarian cancer

Abstract

Objective: To assess clinical characteristics of long-term survivors of advanced epithelial ovarian cancer (EOC) to define a prognostic inflection point for long-term survival.

Methods: A retrospective analysis was undertaken of patients with FIGO stage III or IV EOC treated at one center in South Korea from 2000 to 2012. Patients who survived 5 years or more were identified, and the periods of disease-free survival and overall survival were evaluated for prognostic inflection points to indicate long-term survival. Clinicopathologic data and treatment-associated factors were assessed.

Results: In total, 60 patients survived more than 5 years. Thirty-three (55%) patients experienced disease recurrence and 11 (18%) died due to advanced EOC during a median follow-up period of 92 months (range 61-205). Most recurrence events (32/33, 97%) and deaths (10/11, 91%) occurred within 6 years and 8 years, respectively. Although half the long-term (>8 year) survivors with stage IIIC-IV disease experienced disease recurrence, they had a significantly longer platinum-free interval (P=0.007) and tended to have received aggressive surgical treatments after disease recurrence (P=0.054), as compared with survivors for 5-8 years.

Conclusion: Survival for 8 years might represent a prognostic inflection point for long-term survival in advanced EOC.

Keywords: Advanced ovarian cancer; Cytoreductive surgery; Long-term survivor; Mortality; Overall survival.