Retrospective analysis of prognostic factors in advanced ovarian carcinoma

Abstract

Epithelial ovarian cancer is the Leading cause of death from gynecologic cancer in USA and is the country’s fifth most common cause of cancer mortality in women (Siegel et al., 2015). In our study we reviewed medical records of 82 patients including demographic data and clinico-pathological factors; which include age, performance status and CA 125 level at presentation and nadir, presence of ascites at diagnosis, adequacy of surgery, macroscopic residual, number and type of first-line chemotherapy, neoadjuvent chemotherapy, histological subtypes and stage grading were among the parameters of interest, survival rates were calculated to evaluate them as prognostic factors. Among the predisposing factors are: early menarche, late menopause and nulliparity (Tsilidis et al., 2011). More than 88% of advanced EOC cancer cases are papillary serous adenocarcinoma (McCluggage, 2014). Our patients under study had: median age of the studied population was 50 years (range: 23-75), majority of our patients (61%) were ECOG 1 performance status, (64.6%) of the patients were presented to us with stage IIIC disease. Most of the patients received Taxol Carboplatin as 1st line chemotherapy in our study. Regimens containing platinum have been the standard of care for almost 40 years worldwide, survival was improved when paclitaxel was added to cisplatin, as a result, paclitaxel was added.Carboplatin produces equivalent response rates and survival outcomes to cisplatin, but is associated with less toxicity (Ozols et al., 2003). Results of two first line trials (GOG21856 and ICON757) have shown that patients with FIGO stage III/IV disease with any residual tumor after primary surgery benefit from the addition of bevacizumab to carboplatin and paclitaxel chemotherapy followed by maintenance treatment (Burger et al., 2011 and Perren et al., 2011). In our study, median PFS and OS are 12.5 (95% CI, 9.85-15.15) and 13 (95% CI, 9.82-16.19) for advanced ovarian cancer. Our study shows prognostic effect for age, performance status, presence of ascites at presentation, adequacy of surgery and absence of macroscopic tumor, histological subtype and grading, number of cycles and type of 1st line chemotherapy for advanced ovarian cancer.