Clinical Investigation into Survival Outcomes Among Stage IV Epithelial Ovarian Cancer Patients Receiving Curative Treatment: Indian Setting

Abstract

Objective: Currently, there is scanty data regarding patients specifically with stage IV epithelial ovarian cancer (EOC) as many reports combine analysis with patients staged IIIC. Our objective was to understand the survival outcome in stage IV EOC patients treated with curative intent.

Methods: Data of 895 patients were retrospectively reviewed from the medical records department from the period of January 2014 to December 2018 at Malabar Cancer Centre in India. Patients with stage IV disease were selected for further analysis. Five-year overall survival (OS) and recurrence-free survival (RFS) were examined.

Results: There were a total of 60 patients with stage IV EOC of which only 41 who underwent primary/interval cytoreductive surgery and 11 underwent only chemotherapy. The median follow-up period was 71 months. The overall survival (OS) rates at 2, 3, and 5 years were 69.2%, 47.9%, and 22.5%, respectively. The median OS was 34.5 months (95% CI 18.17-50.82), and median RFS was 12 months (95% CI 10.3-13.7). Patients not operated had worse overall survival compared to those who went surgical debulking (p < 0.013). Ascites (HR 0.383 95% CI 0.16-0.88) and optimal cytoreduction (HR 3.004 95% CI 1.20-7.50) were the only variables found to be significant predictors of overall survival.

Conclusion: Distant metastasis to visceral organs should not be a deterrent for surgeons to achieve curative intent of treatment in stage IV epithelial ovarian cancer.

Keywords: Cytoreduction surgical procedures; Ovarian neoplasms; Survival outcome.