Patterns of Relapse and Survival Analysis of Advanced Epithelial Ovarian Cancers Operated in a Tertiary Cancer Centre

Abstract

Background

Advanced epithelial ovarian cancers have a dismal prognosis with a 5-year survival rate of 29.2%. A relapse rate in excess of 75% is noted in patients who achieve remission following neoadjuvant chemotherapy and cytoreductive surgery. Our study aims to find out the progression-free survival and overall survival of advanced epithelial ovarian cancers in South Indian population.

Materials and Methods

Demographic data, neoadjuvant treatment and surgery details, recurrence, and survival status of patients operated for advanced ovarian cancer in our department from year 2015 till 2018 were retrospectively collected through medical records. Statistical analyses were performed using SPSS version 25.

Results

Our study included 111 patients with the majority staged as IIIC (82%). 107 patients received neoadjuvant chemotherapy. Six patients were lost to follow-up. The median pre- and post-chemotherapy CA 125 level was 694 IU/L and 33.5 IU/L, respectively. Optimal cytoreduction was achieved in 87.6% of patients. At a median follow-up of 24 months, median progression-free survival was 30 months (95% CI: 26.5–34.5) in the optimally cytoreduced versus 13 months (95% CI: 10.3–15.4) in the suboptimally cytoreduced patients (P0.005). The median overall survival was 36 months (95% CI: 32–39) in optimally cytoreduced versus 19 months (95% CI: 17.6–20.3) in suboptimally cytoreduced patients (P0.001).

Conclusion

Patients achieving optimal cytoreduction after neoadjuvant chemotherapy have significantly lower recurrence rates, higher progression-free survival, and overall survival rates than those suboptimally cytoreduced. Results from our centre are equivalent to apex centres in India.