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Abstract
Introduction/Background The aim of this study was to investigate whether women who developed an overactive immune system disorder (autoimmune disease and autoimmune-related disorder) following diagnosis of high-grade epithelial ovarian cancer had a better overall survival than those who did not develop such a disorder. We also performed secondary analyses of the overall survival of patients with pre-existing immune system disorders.
Methodology Women treated for high-grade serous, endometrioid, or transitional cell ovarian, fallopian tube, or peritoneal cancer FIGO stage III or IV at a Swiss cantonal gynecological cancer center between 2008 and 2022 were included in this retrospective study. Demographic and clinical data were extracted from electronic medical records. We conducted Kaplan-Meier estimates of survival function, log-rank tests for equality of survivor, and the Cox proportional hazards method to assess predictor variables.
Results Of the 127 patients, eight (6%) developed an overactive immune system disorder following cancer diagnosis. The median time from cancer diagnosis to overactive immune system disorder was 3 years (IQR 2–5). These women survived a median of 3,086 days (IQR 1,848–3,924) versus 879 days (IQR 544–1,728) for those who did not develop a disorder after cancer diagnosis (p=0.0004). The median overall survival of the nine women with pre-existing autoimmune-related disorders was 1,093 days (IQR 716–1,705), similar to those who never had an immune system disorder. Multivariate analyses showed that older age at diagnosis (p=0.005, HR 1.04, 95% CI 1.01–1.06) and higher residual tumor burden (p=0.041, HR 1.71, 95% CI 1.02–2.85) were associated with a poorer prognosis, and developing an overactive immune system disorder after cancer diagnosis was associated with longer survival (p=0.008, HR 0.07, 95% CI 0.01–0.50).
Conclusion Clinical manifestations of overactive immune system disorders following ovarian cancer diagnosis were associated with better overall survival (8.5 versus 2.4 years), indicating that an overactive immune response may improve cancer control.
Disclosures There are no financial conflicts of interest to disclose.
