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. 2021 Nov 17;7(11):e25976.
doi: 10.2196/25976.

Long-Term Survival Among Histological Subtypes in Advanced Epithelial Ovarian Cancer: Population-Based Study Using the Surveillance, Epidemiology, and End Results Database

Shi-Ping Yang #  1 , Hui-Luan Su #  2 , Xiu-Bei Chen #  3 , Li Hua  4 , Jian-Xian Chen  5 , Min Hu  4 , Jian Lei  4 , San-Gang Wu  3 , Juan Zhou  4
Affiliations

Long-Term Survival Among Histological Subtypes in Advanced Epithelial Ovarian Cancer: Population-Based Study Using the Surveillance, Epidemiology, and End Results Database

Shi-Ping Yang et al. JMIR Public Health Surveill. .

Abstract

Background: Actual long-term survival rates for advanced epithelial ovarian cancer (EOC) are rarely reported.

Objective: This study aimed to assess the role of histological subtypes in predicting the prognosis among long-term survivors (≥5 years) of advanced EOC.

Methods: We performed a retrospective analysis of data among patients with stage III-IV EOC diagnosed from 2000 to 2014 using the Surveillance, Epidemiology, and End Results cancer data of the United States. We used the chi-square test, Kaplan-Meier analysis, and multivariate Cox proportional hazards model for the analyses.

Results: We included 8050 patients in this study, including 6929 (86.1%), 743 (9.2%), 237 (2.9%), and 141 (1.8%) patients with serous, endometrioid, clear cell, and mucinous tumors, respectively. With a median follow-up of 91 months, the most common cause of death was primary ovarian cancer (80.3%), followed by other cancers (8.1%), other causes of death (7.3%), cardiac-related death (3.2%), and nonmalignant pulmonary disease (3.2%). Patients with the serous subtype were more likely to die from primary ovarian cancer, and patients with the mucinous subtype were more likely to die from other cancers and cardiac-related disease. Multivariate Cox analysis showed that patients with endometrioid (hazard ratio [HR] 0.534, P<.001), mucinous (HR 0.454, P<.001), and clear cell (HR 0.563, P<.001) subtypes showed better ovarian cancer-specific survival than those with the serous subtype. Similar results were found regarding overall survival. However, ovarian cancer-specific survival and overall survival were comparable among those with endometrioid, clear cell, and mucinous tumors.

Conclusions: Ovarian cancer remains the primary cause of death in long-term ovarian cancer survivors. Moreover, the probability of death was significantly different among those with different histological subtypes. It is important for clinicians to individualize the surveillance program for long-term ovarian cancer survivors.

Keywords: Surveillance, Epidemiology, and End Results; cancer; epidemiology; epithelial; histology; long-term outcome; oncology; ovarian; ovarian epithelial carcinoma; ovary; reproductive health; surveillance; survival; survival rate; survivors; survivorship; women’s health.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Flow diagram of the study cohort.
Figure 2
Figure 2
Causes of death after stratification by years of survival after diagnosis of epithelial ovarian cancer for long-term survivors: (A) the entire cohort; (B) patients aged <50 years; (C) patients aged 50-64 years; and (D) patients aged ≥65 years.
Figure 3
Figure 3
Comparison of ovarian cancer–specific survival (A) and overall survival (B) among the 4 histological subtypes of the epithelial ovarian cancer diagnosed from 2000 to 2014 using the Surveillance, Epidemiology, and End Results cancer data of the United States.
Figure 4
Figure 4
The evaluation of the proportional hazards assumption in ovarian cancer-specific survival (A and C) and overall survival (B and D) among the different histological subtypes of the epithelial ovarian cancer from 2000 to 2014 using the Surveillance, Epidemiology, and End Results cancer data of the United States.
Figure 5
Figure 5
Ovarian cancer-specific survival curves (A) and overall survival curves (B) between serous cancer and non-serous cancer from 2000 to 2014 using the Surveillance, Epidemiology, and End Results cancer data of the United States.
See this image and copyright information in PMC

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