JMIR Publications

ABSTRACT

Background:

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

Objective:

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 on 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 non-malignant pulmonary disease (3.2%). Patients with serous subtype were more likely to die from primary ovarian cancer and patients with mucinous subtype were more likely to die from other cancers and cardiac-related disease. Multivariate Cox analysis showed 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, the ovarian cancer-specific survival and OS 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 is a significant difference among those with different histological subtypes. It is important for clinicians to individualize the surveillance program for long-term ovarian cancer survivors.