Predictors of Survival Outcomes After Primary Treatment of Epithelial Ovarian Cancer in Lagos, Nigeria

Abstract

Purpose: This study was designed to investigate the clinicopathologic predictors of progression-free survival (PFS) and overall survival (OS) in patients with epithelial ovarian cancer (EOC) following primary treatment in Lagos, Nigeria.

Materials and methods: Using data from a retrospective cohort of 126 patients who received treatment for EOC between 2010 and 2018, we identified 83 patients with a complete clinical record for subsequent data analysis. Patients' demographics and updated 2-year follow-up status were abstracted from medical records. Kaplan-Meier survival curves were compared using the log-rank test, and Cox proportional hazard models were used for multivariate analysis to identify independent predictors of survivals following treatment in EOC patients.

Results: The median PFS and OS were 12 and 24 months, respectively. After adjusting for covariates in the multivariate analysis, younger age ≤ 55 years (hazard ratio [HR] = 0.40; 95% CI, 0.22 to 0.74; P = .01) and International Federation of Gynecology and Obstetrics (FIGO) stage I/II (HR = 0.02; 95% CI, 0.01 to 0.08; P = .01) were independent predictors of improved PFS, whereas being premenopausal (HR = 2.34; 95% CI, 1.16 to 4.75; P = .02) was an independent predictor of reduced OS after 2-year follow-up.

Conclusion: PFS could be predicted by the age and FIGO stage of the disease, whereas menopausal status was predictive of OS in patients with EOC. This knowledge should form the basis for counseling patients with ovarian cancer during their primary treatment and lend support to the importance of aggressive follow-up and monitoring for the older, premenopausal patients and those with an advanced stage of epithelial ovarian cancer. However, robust longitudinal research should be carried out to provide additional reliable insight to this information.

FIG 1

Kaplan-Meier curve of progression-free survival (PFS) and overall survival (OS) stratified by age—age (≤ 55 v > 55 years) was not associated with PFS (P = .937) and OS (P = .942).

FIG 2

Kaplan-Meier curve of progression-free survival (PFS) and overall survival (OS) stratified by parity—the patient’s parity (≤ 2 v > 2) was associated with OS (P = .024) but not PFS (P = .253).

FIG 3

Kaplan-Meier curve of progression-free survival (PFS) and overall survival (OS) stratified by menopausal status—menopausal status (premenopause v postmenopause) was associated with OS (P = .037) but not PFS (P = .513).

FIG 4

Kaplan-Meier curve of progression-free survival (PFS) and overall survival (OS) stratified by surgical debulking status—surgical debulking status (optimal v suboptimal) was associated with PFS (P = .001) and OS (P = .008). Optimal debulking is defined as when the residual disease is < 1 cm.

FIG 5

Kaplan-Meier curve of progression-free survival (PFS) and overall survival (OS) stratified by International Federation of Gynecology and Obstetrics (FIGO) staging—FIGO stage (early v advanced) was associated with PFS (P = .001) and OS (P = .005).