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Prognostic factors in young women with epithelial ovarian cancer: the Young Ovarian Cancer-Care (YOC-Care) study
  1. Leticia Azcona1,
  2. Marta Heras2,
  3. Octavio Arencibia3,
  4. Lucas Minig4,
  5. Lola Marti5,
  6. Andreea Baciu6,
  7. Juan Cespedes7,
  8. Isabel Niguez8,
  9. Blanca Gil-Ibanez9,
  10. Berta Díaz-Feijoo10,
  11. Lidia Maria Melero11,
  12. Josefa Marcos Sanmartin12,
  13. Jose Garcia-Villayzan13,
  14. Benjamina Gomez14,
  15. Manel Montesinos15,
  16. Sofia Herrero16,
  17. Juan Gilabert-Estelles17,
  18. Maria F Chereguini18,
  19. Mikel Gorostidi7,19,20 and
  20. Ignacio Zapardiel21
  21. On behalf of YOC-Care Group Collaborative
  1. 1Obstetrics and Gynecology, Hospital Universitario Virgen Macarena, Sevilla, Spain
  2. 2Obstetrics and Gynecology, Hospital Universitario Santa Cristina, Madrid, Spain
  3. 3Gynecology, University Maternal Hospital Canary Islands, Las Palmas, Spain
  4. 4Gynecologic Oncology, Valencian Institute of Oncology (IVO), Valencia, Spain
  5. 5Gynecological Oncology, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
  6. 6Gynecology Department, La Paz University Hospital, Madrid, Spain
  7. 7Obstetrics and Gynecology, Hospital Universitario de Donostia, San Sebastian, Spain
  8. 8Gynecology and Obstetrics, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar-Murcia, Spain
  9. 9Obstetrics and Gynecology, Hospital Universitario 12 de Octubre, Madrid, Spain
  10. 10Obstetrics and Gynecology, Hospital Clinic de Barcelona, Barcelona, Spain
  11. 11Gynecology Department, Hospital Universitario Virgen del Rocío, Sevilla, Spain
  12. 12Obstetrics and Gynecology, Hospital General Universitari d’Alacant, Alicante, Spain
  13. 13Gynecology Department, Fundación Jiménez Díaz, Madrid, Spain
  14. 14Gynecology Department, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Spain
  15. 15Department of Obstetrics and Gynecology, University Hospital La Fe, Valencia, Spain
  16. 16Gynecology Department, Hospital Universitario Puerta de Hierro, Madrid, Spain
  17. 17Gynecologic Oncology, General University Hospital Consortium of Valencia, Valencia, Spain
  18. 18Gynaecology, MD Anderson Cancer Center, Madrid, Spain
  19. 19Systemic Diseases, Biogipuzkoa Health Research Institute, Donostia-San Sebastian, Spain
  20. 20School of Medicine, Basque Country University, San Sebastián, Spain
  21. 21Gynecologic Oncology, La Paz University Hospital, Madrid, Spain
  1. Correspondence to Dr Mikel Gorostidi, Obstetrics and Gynecology Department, Hospital Universitario de Donostia, San Sebastian, Spain; mgorostidi{at}sego.es

Abstract

Objective To determine oncological outcomes and to identify prognostic factors in women aged <45 years with epithelial ovarian cancer.

Methods A multicenter retrospective study was performed of patients treated for epithelial ovarian cancer aged <45 years between January 2010 and December 2019.

Results A total of 998 patients with epithelial ovarian cancer from 55 different institutions in Spain were collected. The median age of the study population was 40.8 years (range 35.6–43.4). The grouped International Federation of Gynecology and Obstetrics (FIGO) stage distribution was 508 (50.9%) patients in initial stages (I and II) and 490 (49.1%) with advanced stages (III and IV). Three hundred and twenty-five (32.6%) patients presented with recurrent disease after a median follow-up of 33.1 months (range 16.1–66.4). The type of staging surgery (incomplete vs complete), type of initial treatment modality (primary cytoreduction vs interval surgery), and amount of residual disease were all significantly associated with overall survival. Tumor rupture was noted in 288 (27.9%) cases, but it was not associated with oncologic outcomes (p=0.11 for overall survival). In the multivariate analysis, the response based on radiological findings (HR 3.24, 95% CI 2.14 to 4.91 for partial response; HR 6.93, 95% CI 4.79 to 10.04 for progression), neoadjuvant chemotherapy (HR 1.42, 95% CI 1.04 to 1.94), and FIGO stage (HR 1.68, 95% CI 1.40 to 2.02) were identified as independent prognostic factors associated with worse oncologic outcomes (p<0.001).

Conclusion The partial and progression radiology-based response after chemotherapy, neoadjuvant chemotherapy, and advanced FIGO stage are independent prognostic factors associated with worse oncological outcomes in women aged <45 years with epithelial ovarian cancer.

  • Carcinoma, Ovarian Epithelial
  • Medical Oncology
  • Surgical Oncology

Data availability statement

In accordance with the journal’s guidelines, we will provide our data for independent analysis by a selected team by the Editorial Team for the purposes of additional data analysis or for the reproducibility of this study in other centers if such is requested.

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Data availability statement

In accordance with the journal’s guidelines, we will provide our data for independent analysis by a selected team by the Editorial Team for the purposes of additional data analysis or for the reproducibility of this study in other centers if such is requested.

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Footnotes

  • Twitter @ORCID: 0000-0002-8064-7319, @BlancaG24130028, @Bertadiazfeijoo#, @MMontesinos_Alb, @mgorostidi

  • Collaborators YOC-Care Group Collaborative: Alcalá MM (Hospital de Poniente, Almería), Alkourdi A (Hospital Virgen de las Nieves, Granada), Alonso M (Hospital Universitario de Guadalajara, Guadalajara), Alonso T (Hospital Universitario de Burgos, Burgos), Álvarez R (Hospital Universitario Santa Cristina, Madrid), Amengual J (Hospital Universitario Son Espases, Palma de Mallorca), Aparicio I (Complejo Hospitalario Universitario, Pontevedra), Arencibia O (Hospital Universitario Materno Infantil, Canarias), Azcona L (Hospital Universitario Virgen de la Macarena, Sevilla), Baciu A (La Paz University Hospital, Madrid), Bayón E (Hospital Clínico de Valladolid, Valladolid), Bellete C (Hospital General de Segovia, Segovia), Bellón M (Hospital Clínico San Carlos, Madrid), Boldó A (Hospital La Plana, Castellón), Brunel I (Hospital Quirón Málaga, Málaga), Bustillo S (Hospital Universitario de Salamanca, Salamanca), Cabezas MN (Hospital Universitario Virgen de la Macarena, Sevilla), Cano A (Hospital Universitario Fundación Alcorcón, Madrid), Cárdenas L (Hospital Josep Trueta, Gerona), Chacón E (Clínica Universitaria Navarra, Navarra), Coronado P (Hospital Clínico San Carlos, Madrid), Corraliza V (Hospital Universitario Ramón y Cajal, Madrid), Corredera FJ (Hospital Universitario de Salamanca, Salamanca), Couso A (Hospital Príncipe de Asturias, Madrid), Díaz B (Hospital Clinic Barcelona, Barcelona), Duch S (Hospital Universitario Infanta Sofía, Madrid), Fernández M (MD Anderson Cancer Center, Madrid), Fernández MJ (Complejo Asistencial de Zamora, Zamora), Fidalgo S (Hospital Universitario Central de Asturias, Asturias), García J (Fundación Jiménez Díaz, Madrid), Gil-Ibánez B (Gynecologic Oncology and Minimally Invasive Surgery Unit, Gynecology and Obstetrics Department, University Hospital 12 de Octubre, Madrid), Gilabert-Estelles J (Hospital Universitari Valencia, Valencia), Gómez AI (Hospital General de Segovia, Segovia), Gómez B (Hospital Virgen de la Arraixaca, Murcia), González L (Hospital Universitario de Torrejón, Madrid), González MH (Hospital Príncipe de Asturias, Madrid), Gorostidi M (Hospital Universitario de Donostia, San Sebastián), Herrero S (Hospital Universitario Puerta de Hierro, Madrid), Hidalgo E (Hospital Universitario San Cecilio, Granada), Iacoponi S (Hospital Quirón Madrid, Madrid), Izquierdo R (Hospital de Igualada, Barcelona), Lamarca M (Hospital Universitario Miguel Servet, Zaragoza), Lara AM (Hospital Virgen de las Nieves, Granada), Lete I (Hospital Universitario Araba, Vitoria), Llueca A (Hospital de Castellón, Castellón), López I (Hospital HM Montepríncipe y San Chinarro, Madrid), López CA (Hospital General Universitario de Ciudad Real, Ciudad Real), Mancebo G (Hospital del Mar, Barcelona), Marcos J (Hospital General Universitario de Alicante, Alicante), Marino M (Hospital Universitario de Salamanca, Salamanca), Martí L (Hospital Universitario Bellvitge, Barcelona), Martínez M (Hospital Virgen de la Luz, Almería), Martínez MC (Hospital Son Llatzer, Palma de Mallorca), Melero LM (Hospital Virgen del Rocío, Sevilla), Minig L (Instituto Valenciano Oncología, Valencia), Montesinos M (Hospital Universitario y Politécnico La Fe, Valencia), Moral R (Hospital Poniente, Almería), Morales S (Hospital Universitario Infanta Leonor, Madrid), Negredo I (Hospital Miguel Servet, Zaragoza), Nieto A (Hospital Virgen de la Arrixaca, Murcia), Níguez I (Hospital Virgen de la Arrixaca, Murcia), Ribot L (Hospital Universitario Parc Tauli, Barcelona), Rosado C (Hospital de Mataró, Barcelona), Sancho V (Hospital Universitario de Salamanca, Salamanca), Tetilla V (Hospital General de Segovia, Segovia), Torres MC (Hospital del Perpetuo Socorro, Badajoz), Valencia I (Hospital Universitario Puerto Real, Cádiz), Veiga A (Hospital General Universitario Gregorio Marañón, Madrid), Vidal R (Complejo Hospitalario de Pontevedra, Pontevedra), Vilches JC (Hospital Quirón Málaga, Málaga).

  • Contributors LA: conceptualization, data curation, formal analysis, investigation, methodology, project administration, resources, software, supervision, validation, visualization, writing - original draft, writing - review and editing. MH: data curation, validation, visualization, writing - original draft, review and editing. OA: data curation, validation, visualization, writing - original draft, review and editing. LM: data curation, validation, visualization, writing - original draft, review and editing. LM: data curation, validation, visualization, writing - original draft, review and editing. AB: data curation, validation, visualization, writing - original draft, review and editing. JC: data curation, validation; visualization; writing - original draft, review and editing. IN: data curation, validation, visualization, writing - original draft, review and editing. BG-I: data curation, validation, visualization, writing - original draft, review and editing. BD-F: data curation, validation, visualization, writing - original draft, review and editing. LMM: data curation, validation, visualization, writing - original draft, review and editing. JM: data curation, validation, visualization, writing - original draft, review and editing. JG-V: data curation, validation, visualization, writing - original draft, review and editing. BG: data curation, validation, visualization, writing - original draft, review and editing. MM: data curation, validation, visualization, writing - original draft, review and editing. SH: data curation, validation, visualization, writing - original draft, review and editing. JG-E: data curation, validation, visualization, writing - original draft, review and editing. MF-C: data curation, validation, visualization, writing - original draft, review and editing. MG: conceptualization, data curation, formal analysis, investigation, methodology, project administration, resources, software, supervision, validation, visualization, writing - original draft, writing - review and editing. IZ: guarantor, conceptualization, data curation, formal analysis, investigation, methodology, project administration, resources, software, supervision, validation, visualization, writing - original draft, writing - review and editing. YOC-Care Group Collaborative: data curation.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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