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Abstract
Introduction/Background A subset of patients with advanced epithelial ovarian cancer(EOC) are long term survivors(LTS).The underlying prognostic factors associated with survivorship may provide individualized follow-up strategies.We aimed to characterize the patients with advanced EOC with long and short-term survival.
Methodology We conducted a retrospective analysis of patients diagnosed with advanced EOC(FIGO stage III/IV) treated at a single center, between 2002–2020.Characteristics of short-term survivors (STS), women who survived <2 years, were compared to LTS,patients who lived >10 years from diagnosis.
Results Among 822 patients with advanced EOC,112(14%) women survived <2years, while 139(17%) survived >10 years.Histology,CA125 levels,and debulking approach were not significantly prognostic of survivorship.
Survival of advanced epithetical ovarian carcinoma by BRCA mutation status
LTS were younger at diagnosis,(median age of 56.5 in LTS, vs. 70 in STS,p<0.0001).The majority were diagnosed with stage III,(97%,LTS, vs. 67%,STS).BRCA mutation status was the strongest prognostic factor among LTS(OR=21,p<0.001).Forty-two-percent of LTS were BRCA mutation carriers,whereas most STS were BRCA Wildtype(90%,p<0.001).LTS predominantly had a platinum sensitive disease(98.4%, LTS, vs. 21.6% STS,p<0.0001).Optimal cytoreductive surgery was performed among almost all LTS(41.9%,STS vs. 88.7%,LTS, p<0.0001).A greater proportion of LTS received weekly paclitaxel carboplatin therapy compared to STS(49.2%,LTS vs. 31.6%,STS, p<0.01). Bevacizumab and PARP inhibitors were associated with long term survivorship (p=0.01, and p<0.001 resepctively.The total population with advanced stage(III-IV) had a mOS of 61.77 months, and median progression free survival(mPFS) of 15.2 months.While women with a BRCA mutation had a longer mOS(86 months) and mPFS (19 months) compared to the BRCA WT population(51, and 13 months, respectively,p=0.043),with specifically longer mOS and mPFS among the BRCA2 population in comparison to BRCA1 carriers(112, and 30 months,respectively,p=0.01).
Conclusion The LTS and STS with advanced EOC may be identified early in the clinical assessment, based on distinct patient characteristics associated with survivorship, which are critical in developing a personalized treatment and follow-up approach.
Disclosures none