Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2022 Feb 1;139(2):157-162.
doi: 10.1097/AOG.0000000000004642.

Symptoms of Women With High-Risk Early-Stage Ovarian Cancer

John K Chan  1 , Chunqiao Tian, Joshua P Kesterson, Bradley J Monk, Daniel S Kapp, Brittany Davidson, Sharon Robertson, Larry J Copeland, Joan L Walker, Robert M Wenham, Yovanni Casablanca, Nick M Spirtos, Krishnansu S Tewari, Jeffrey G Bell
Affiliations
Clinical Trial

Symptoms of Women With High-Risk Early-Stage Ovarian Cancer

John K Chan et al. Obstet Gynecol. .

Abstract

Objective: To assess the presentation, characteristics, and prognostic significance of symptoms in patients with high-risk early-stage epithelial ovarian cancer.

Methods: A retrospective chart review was performed on all patients enrolled in a phase III clinical trial (GOG 157). All patients had surgically staged, high-risk early-stage epithelial ovarian cancer (stage IA-IB and grade 3, any clear cell, stage IC or II). Chi-square and Kaplan-Meier estimates and Cox proportional hazards models were used for statistical analyses.

Results: Of 419 patients evaluated for symptoms, 301 (72%) presented with one or more symptoms, and 118 (28%) were asymptomatic but had a mass found on examination. Forty percent had only one symptom, and 32% had more than one symptom. Among those with at least one symptom, the most common were abdominal and pelvic pain (31%), and increased girth or fullness (26%). Overall, 23% of patients with tumors 10 cm or smaller, 27% of patients with tumors larger than 10 cm to 15 cm, and 46% of patients with tumors larger than 15 cm had multiple symptoms (P<.001). There was no significant difference in presentation of symptoms based on age, stage, or histologic subtype. Symptoms at diagnosis were not associated with recurrence or survival.

Conclusion: More than 70% of patients with high-risk early-stage, epithelial ovarian cancer present with one or more symptoms, with the most common being abdominal or pelvic pain. The proportion of women with symptoms and the number of symptoms increase with enlarging tumor size.

PubMed Disclaimer

Conflict of interest statement

Financial Disclosure Dr. John K. Chan received funds from NRG/GOG for consortium trial participation and funds for research, consultant, and speaker bureau from AbbVie, Acerta, Aravive, AstraZeneca, Clovis, Eisai, GlaxoSmithKline, Merck, Myriad, Roche, Seagen. Bradley J. Monk is on the board for the GOG Foundation and is a paid consultant. Brittany Davidson received money from GSK. Joan L. Walker disclosed that Stephenson Cancer Center is an NRG Oncology Laps site and she is NCORP PI, but unrelated to this study. Robert Wenham received GOG funds for consortium trial participation, money from Regeneron, Tesaro/GSK, and Genentech. In the past 3 years, he has received funds from Seagen, Ovation Diagnostics, AbbVie, Clovis, AstraZeneca, Prescient Therapeutics, and Merck. Yovanni Casablanca received funding from AstraZeneca. Nick M. Spirtos received funding from John Wiley and Sons, and NRG Oncology. The other authors did not report any potential conflicts of interest.

Figures

Figure 1:
Figure 1:
Characteristics of symptoms associated with early-stage high-risk ovarian cancer patients
Figure 2:
Figure 2:
Presentation of symptoms based on tumor size.
Figure 3:
Figure 3:
A. Relapse-free survival based on symptoms (log-rank test P=.712). B. Overall survival based on symptoms (log-rank test P=.917).
Figure 4:
Figure 4:
Ovarian cancer symptoms: early versus advanced stage. Data from early-stage cancer based on current report and data from advanced-stage disease from historical report.
See this image and copyright information in PMC

Comment in

References

    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020; 70(1):7–30. - PubMed
    1. Chan JK, Cheung MK, Husain A, et al.: Patterns and progress in ovarian cancer over 14 years. Obstet Gynecol 2006; 108:521–528. - PubMed
    1. Andersen MR, Goff BA, Lowe KA, et al.: Combining a symptoms index with CA 125 to improve detection of ovarian cancer. Cancer 2008; 113:484–489. - PMC - PubMed
    1. Goff BA, Mandel L, Muntz HG, et al.: Ovarian carcinoma diagnosis. Cancer 2000; 89:2068–20675. - PubMed
    1. Goff BA, Mandel LS, Drescher CW, et al.: Development of an ovarian cancer symptom index: possibilities for earlier detection. Cancer 2007; 109:221–227. - PubMed

Publication types