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Prognostic factors for high-risk early-stage epithelial ovarian cancer: a Gynecologic Oncology Group study.
Cancer. 2008 May 15; 112(10):2202-10.C

Abstract

BACKGROUND

The purpose was to identify the factors predictive of recurrence and survival in patients with high-risk (stage I, grade 3; stage IC, stage II, or clear cell) epithelial ovarian cancer after adjuvant therapy.

METHODS

Data was extracted from patients who underwent primary surgery followed by adjuvant therapy in 2 randomized trials by the Gynecologic Oncology Group (Protocols 95 and 157). Kaplan-Meier survival estimates and Cox proportional hazards model adjusted for covariates were used for analyses.

RESULTS

Of 506 patients (median age = 56.2 years), 347 (68.6%) had stage I and 159 (31.4%) had stage II cancers. The 5-year recurrence-free (RFS) and overall survivals (OS) were 75.5% and 81.7%, respectively. On multivariate analysis, older age, higher stage, higher grade, and malignant cytology were independent prognostic factors predictive for recurrence and poorer survival. The risk of recurrence was higher for those >/=60 versus < 60 years (hazards ratio [HR] = 1.57, 95% confidence interval [CI], 1.12-2.19), stage II (stage II: HR = 2.70, 95% CI, 1.41-5.16) versus stage IA or IB, grade 2 (HR = 1.84, 95% CI, 1.04-3.27) and grade 3 (HR = 2.47, 95% CI, 1.39-4.37) versus grade 1, and positive versus negative cytology (HR = 1.72, 95% CI, 1.21-2.45). By using these factors in a prognostic index, those with low-risk (no or 1 risk factor), intermediate-risk (2 factors), and high-risk (3-4 risk factors) disease had survivals of 88%, 82%, and 75%, respectively (P < .05).

CONCLUSIONS

Age, stage, grade, and cytology are important prognostic factors in high-risk early-stage epithelial ovarian cancer. This information may be used in the design of future clinical trials.

Authors+Show Affiliations

Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco School of Medicine, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California 94143-1702, USA. chanjohn@obgyn.ucsf.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18348296

Citation

Chan, John K., et al. "Prognostic Factors for High-risk Early-stage Epithelial Ovarian Cancer: a Gynecologic Oncology Group Study." Cancer, vol. 112, no. 10, 2008, pp. 2202-10.
Chan JK, Tian C, Monk BJ, et al. Prognostic factors for high-risk early-stage epithelial ovarian cancer: a Gynecologic Oncology Group study. Cancer. 2008;112(10):2202-10.
Chan, J. K., Tian, C., Monk, B. J., Herzog, T., Kapp, D. S., Bell, J., & Young, R. C. (2008). Prognostic factors for high-risk early-stage epithelial ovarian cancer: a Gynecologic Oncology Group study. Cancer, 112(10), 2202-10. https://doi.org/10.1002/cncr.23390
Chan JK, et al. Prognostic Factors for High-risk Early-stage Epithelial Ovarian Cancer: a Gynecologic Oncology Group Study. Cancer. 2008 May 15;112(10):2202-10. PubMed PMID: 18348296.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic factors for high-risk early-stage epithelial ovarian cancer: a Gynecologic Oncology Group study. AU - Chan,John K, AU - Tian,Chunqiao, AU - Monk,Bradley J, AU - Herzog,Thomas, AU - Kapp,Daniel S, AU - Bell,Jeffrey, AU - Young,Robert C, AU - ,, PY - 2008/3/19/pubmed PY - 2008/6/5/medline PY - 2008/3/19/entrez SP - 2202 EP - 10 JF - Cancer JO - Cancer VL - 112 IS - 10 N2 - BACKGROUND: The purpose was to identify the factors predictive of recurrence and survival in patients with high-risk (stage I, grade 3; stage IC, stage II, or clear cell) epithelial ovarian cancer after adjuvant therapy. METHODS: Data was extracted from patients who underwent primary surgery followed by adjuvant therapy in 2 randomized trials by the Gynecologic Oncology Group (Protocols 95 and 157). Kaplan-Meier survival estimates and Cox proportional hazards model adjusted for covariates were used for analyses. RESULTS: Of 506 patients (median age = 56.2 years), 347 (68.6%) had stage I and 159 (31.4%) had stage II cancers. The 5-year recurrence-free (RFS) and overall survivals (OS) were 75.5% and 81.7%, respectively. On multivariate analysis, older age, higher stage, higher grade, and malignant cytology were independent prognostic factors predictive for recurrence and poorer survival. The risk of recurrence was higher for those >/=60 versus < 60 years (hazards ratio [HR] = 1.57, 95% confidence interval [CI], 1.12-2.19), stage II (stage II: HR = 2.70, 95% CI, 1.41-5.16) versus stage IA or IB, grade 2 (HR = 1.84, 95% CI, 1.04-3.27) and grade 3 (HR = 2.47, 95% CI, 1.39-4.37) versus grade 1, and positive versus negative cytology (HR = 1.72, 95% CI, 1.21-2.45). By using these factors in a prognostic index, those with low-risk (no or 1 risk factor), intermediate-risk (2 factors), and high-risk (3-4 risk factors) disease had survivals of 88%, 82%, and 75%, respectively (P < .05). CONCLUSIONS: Age, stage, grade, and cytology are important prognostic factors in high-risk early-stage epithelial ovarian cancer. This information may be used in the design of future clinical trials. SN - 0008-543X UR - https://www.unboundmedicine.com/medline/citation/18348296/Prognostic_factors_for_high_risk_early_stage_epithelial_ovarian_cancer:_a_Gynecologic_Oncology_Group_study_ L2 - https://doi.org/10.1002/cncr.23390 DB - PRIME DP - Unbound Medicine ER -