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Prognostic value of histological type in stage IV ovarian carcinoma: a retrospective analysis of 223 patients.

Mizuno M, Kajiyama H, Shibata K, Mizuno K, Kawai M, Nagasaka T, Kikkawa F - Br. J. Cancer (2015)

Bottom Line: This study aimed to compare the survival of patients with serous or endometrioid tumours (S/E) and clear cell or mucinous tumours (non-S/E).The median overall survivals (OSs) of the S/E and non-S/E groups were 3.1 and 0.9 years, respectively (P<0.001).Therefore, careful management and development of new strategies are required.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Japan.

ABSTRACT

Background: Patients with FIGO stage IV epithelial ovarian carcinoma have a poor but non-uniform prognosis. This study aimed to compare the survival of patients with serous or endometrioid tumours (S/E) and clear cell or mucinous tumours (non-S/E).

Methods: Data for 223 patients who underwent surgery between 1987 and 2010 and were diagnosed by centralized pathology review and were retrospectively analysed. The patients included 169 with S/E tumours and 54 with non-S/E tumours.

Results: The median overall survivals (OSs) of the S/E and non-S/E groups were 3.1 and 0.9 years, respectively (P<0.001). Six patients (2.7%), all with non-S/E tumours, died within 6 weeks after the initial surgery. Multivariate OS analysis revealed that performance status, residual tumor, metastatic sites, no debulking surgery, and non-S/E tumours were independent poor prognostic factors. For patients with non-S/E tumours, prognosis was more favourable for single-organ metastasis, except for liver or distant lymph nodes, no residual tumor, and resection of metastasis (median OS: 4.1, 4.6, and 2.6 years, respectively).

Conclusions: In stage IV ovarian carcinoma, non-S/E tumours are associated with a significantly poorer prognosis and higher rates of early mortality compared to S/E tumours. Therefore, careful management and development of new strategies are required.

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Overall survival curves according to the metastatic sites for stage IV patients either with residual tumor vs without residual tumor in each group; serous or endometrioid tumours (S/E group) and clear cell, mucinous, and other tumours (non-S/E group). (A) Other single organ, (B) pleural effusion, and (C) liver and lymph nodes.
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fig1: Overall survival curves according to the metastatic sites for stage IV patients either with residual tumor vs without residual tumor in each group; serous or endometrioid tumours (S/E group) and clear cell, mucinous, and other tumours (non-S/E group). (A) Other single organ, (B) pleural effusion, and (C) liver and lymph nodes.

Mentions: The median OS times of the S/E and non-S/E groups were 3.1 (95% confidence interval (CI), 1.9–3.2) and 0.9 (95% CI, 0.6–1.3) years, respectively (P<0.001), and the 5-year OSs for these groups were 31 and 16%, respectively. The median OS according to histological type based on univariate analysis is shown in Table 2. The prognosis of the non-S/E group was significantly worse in relation to many variables, and the median OS for this group was particularly low for patients who had metastases to multiple organs (OS 0.26 years), PS>2 (0.5 years), and ⩾1000 ml ascites volume (0.5 years). However, the survival of patients with non-S/E tumours was similar to that of those with S/E tumours according to each of the following factors: metastasis to other single organs, which was defined as metastasis other than pleural effusion or to the liver or distant lymph nodes (median OS: 4.1 vs 3.9 years, P=0.871); <1 cm residual tumor (4.6 vs 4.2, P=0.258); and resection of metastatic sites (4.2 vs 2.6 years, P=0.258). When analysing patients based on metastatic site, there were significant differences in OS for those in the non-S/E group who had metastasis to other single organs vs pleural effusion (P=0.038) and for those who had metastasis to other single organs vs to multiple organs (P=0.020), but there were no differences in OS in the S/E group based on metastatic site. Furthermore, the prognosis in each metastatic site was analysed for patients with residual tumor compared with patients without residual tumor (Figure 1). In the S/E group, there was a significant difference in other single organs between patients with residual tumor and those without residual tumor (P=0.020, Figure 1A), but there was no difference in pleural effusion (Figure 1B). In the non-S/E group, although there was no significant difference in each metastatic site, the prognosis of other single organs was more favourable for no residual tumor (5-year OS: residual (+), 32% vs residual (−), 72%, P=0.549, Figure 1A).


Prognostic value of histological type in stage IV ovarian carcinoma: a retrospective analysis of 223 patients.

Mizuno M, Kajiyama H, Shibata K, Mizuno K, Kawai M, Nagasaka T, Kikkawa F - Br. J. Cancer (2015)

Overall survival curves according to the metastatic sites for stage IV patients either with residual tumor vs without residual tumor in each group; serous or endometrioid tumours (S/E group) and clear cell, mucinous, and other tumours (non-S/E group). (A) Other single organ, (B) pleural effusion, and (C) liver and lymph nodes.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4402461&req=5

fig1: Overall survival curves according to the metastatic sites for stage IV patients either with residual tumor vs without residual tumor in each group; serous or endometrioid tumours (S/E group) and clear cell, mucinous, and other tumours (non-S/E group). (A) Other single organ, (B) pleural effusion, and (C) liver and lymph nodes.
Mentions: The median OS times of the S/E and non-S/E groups were 3.1 (95% confidence interval (CI), 1.9–3.2) and 0.9 (95% CI, 0.6–1.3) years, respectively (P<0.001), and the 5-year OSs for these groups were 31 and 16%, respectively. The median OS according to histological type based on univariate analysis is shown in Table 2. The prognosis of the non-S/E group was significantly worse in relation to many variables, and the median OS for this group was particularly low for patients who had metastases to multiple organs (OS 0.26 years), PS>2 (0.5 years), and ⩾1000 ml ascites volume (0.5 years). However, the survival of patients with non-S/E tumours was similar to that of those with S/E tumours according to each of the following factors: metastasis to other single organs, which was defined as metastasis other than pleural effusion or to the liver or distant lymph nodes (median OS: 4.1 vs 3.9 years, P=0.871); <1 cm residual tumor (4.6 vs 4.2, P=0.258); and resection of metastatic sites (4.2 vs 2.6 years, P=0.258). When analysing patients based on metastatic site, there were significant differences in OS for those in the non-S/E group who had metastasis to other single organs vs pleural effusion (P=0.038) and for those who had metastasis to other single organs vs to multiple organs (P=0.020), but there were no differences in OS in the S/E group based on metastatic site. Furthermore, the prognosis in each metastatic site was analysed for patients with residual tumor compared with patients without residual tumor (Figure 1). In the S/E group, there was a significant difference in other single organs between patients with residual tumor and those without residual tumor (P=0.020, Figure 1A), but there was no difference in pleural effusion (Figure 1B). In the non-S/E group, although there was no significant difference in each metastatic site, the prognosis of other single organs was more favourable for no residual tumor (5-year OS: residual (+), 32% vs residual (−), 72%, P=0.549, Figure 1A).

Bottom Line: This study aimed to compare the survival of patients with serous or endometrioid tumours (S/E) and clear cell or mucinous tumours (non-S/E).The median overall survivals (OSs) of the S/E and non-S/E groups were 3.1 and 0.9 years, respectively (P<0.001).Therefore, careful management and development of new strategies are required.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Japan.

ABSTRACT

Background: Patients with FIGO stage IV epithelial ovarian carcinoma have a poor but non-uniform prognosis. This study aimed to compare the survival of patients with serous or endometrioid tumours (S/E) and clear cell or mucinous tumours (non-S/E).

Methods: Data for 223 patients who underwent surgery between 1987 and 2010 and were diagnosed by centralized pathology review and were retrospectively analysed. The patients included 169 with S/E tumours and 54 with non-S/E tumours.

Results: The median overall survivals (OSs) of the S/E and non-S/E groups were 3.1 and 0.9 years, respectively (P<0.001). Six patients (2.7%), all with non-S/E tumours, died within 6 weeks after the initial surgery. Multivariate OS analysis revealed that performance status, residual tumor, metastatic sites, no debulking surgery, and non-S/E tumours were independent poor prognostic factors. For patients with non-S/E tumours, prognosis was more favourable for single-organ metastasis, except for liver or distant lymph nodes, no residual tumor, and resection of metastasis (median OS: 4.1, 4.6, and 2.6 years, respectively).

Conclusions: In stage IV ovarian carcinoma, non-S/E tumours are associated with a significantly poorer prognosis and higher rates of early mortality compared to S/E tumours. Therefore, careful management and development of new strategies are required.

Show MeSH
Related in: MedlinePlus