TY - JOUR
T1 - Clinicopathologic characteristics associated with long-term survival in advanced epithelial ovarian cancer
T2 - an NRG Oncology/Gynecologic Oncology Group ancillary data study
AU - Hamilton, C. A.
AU - Miller, A.
AU - Casablanca, Y.
AU - Horowitz, N. S.
AU - Rungruang, B.
AU - Krivak, T. C.
AU - Richard, S. D.
AU - Rodriguez, N.
AU - Birrer, M. J.
AU - Backes, F. J.
AU - Geller, M. A.
AU - Quinn, M.
AU - Goodheart, M. J.
AU - Mutch, D. G.
AU - Kavanagh, J. J.
AU - Maxwell, G. L.
AU - Bookman, M. A.
N1 - Publisher Copyright:
© 2017
PY - 2018/2
Y1 - 2018/2
N2 - Objective: To identify clinicopathologic factors associated with 10-year overall survival in epithelial ovarian cancer (EOC) and primary peritoneal cancer (PPC), and to develop a predictive model identifying long-term survivors. Methods: Demographic, surgical, and clinicopathologic data were abstracted from GOG 182 records. The association between clinical variables and long-term survival (LTS) (> 10 years) was assessed using multivariable regression analysis. Bootstrap methods were used to develop predictive models from known prognostic clinical factors and predictive accuracy was quantified using optimism-adjusted area under the receiver operating characteristic curve (AUC). Results: The analysis dataset included 3010 evaluable patients, of whom 195 survived greater than ten years. These patients were more likely to have better performance status, endometrioid histology, stage III (rather than stage IV) disease, absence of ascites, less extensive preoperative disease distribution, microscopic disease residual following cyoreduction (R0), and decreased complexity of surgery (p < 0.01). Multivariable regression analysis revealed that lower CA-125 levels, absence of ascites, stage, and R0 were significant independent predictors of LTS. A predictive model created using these variables had an AUC = 0.729, which outperformed any of the individual predictors. Conclusions: The absence of ascites, a low CA-125, stage, and R0 at the time of cytoreduction are factors associated with LTS when controlling for other confounders. An extensively annotated clinicopathologic prediction model for LTS fell short of clinical utility suggesting that prognostic molecular profiles are needed to better predict which patients are likely to be long-term survivors.
AB - Objective: To identify clinicopathologic factors associated with 10-year overall survival in epithelial ovarian cancer (EOC) and primary peritoneal cancer (PPC), and to develop a predictive model identifying long-term survivors. Methods: Demographic, surgical, and clinicopathologic data were abstracted from GOG 182 records. The association between clinical variables and long-term survival (LTS) (> 10 years) was assessed using multivariable regression analysis. Bootstrap methods were used to develop predictive models from known prognostic clinical factors and predictive accuracy was quantified using optimism-adjusted area under the receiver operating characteristic curve (AUC). Results: The analysis dataset included 3010 evaluable patients, of whom 195 survived greater than ten years. These patients were more likely to have better performance status, endometrioid histology, stage III (rather than stage IV) disease, absence of ascites, less extensive preoperative disease distribution, microscopic disease residual following cyoreduction (R0), and decreased complexity of surgery (p < 0.01). Multivariable regression analysis revealed that lower CA-125 levels, absence of ascites, stage, and R0 were significant independent predictors of LTS. A predictive model created using these variables had an AUC = 0.729, which outperformed any of the individual predictors. Conclusions: The absence of ascites, a low CA-125, stage, and R0 at the time of cytoreduction are factors associated with LTS when controlling for other confounders. An extensively annotated clinicopathologic prediction model for LTS fell short of clinical utility suggesting that prognostic molecular profiles are needed to better predict which patients are likely to be long-term survivors.
KW - Long-term survival
KW - Ovarian cancer
UR - http://www.scopus.com/inward/record.url?scp=85036548798&partnerID=8YFLogxK
U2 - 10.1016/j.ygyno.2017.11.018
DO - 10.1016/j.ygyno.2017.11.018
M3 - Article
C2 - 29195926
AN - SCOPUS:85036548798
SN - 0090-8258
VL - 148
SP - 275
EP - 280
JO - Gynecologic Oncology
JF - Gynecologic Oncology
IS - 2
ER -