Satyamurthy Anuradha1, Penelope M Webb2, Penny Blomfield3, Alison H Brand4, Michael Friedlander5, Yee Leung6, Andreas Obermair7, Martin K Oehler8, Michael Quinn9, Christopher Steer10, Susan J Jordan2. 1. Gynaecological Cancers Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia. Satyamurthy.Anuradha@qimrberghofer.edu.au. 2. Gynaecological Cancers Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia. 3. Gynaecologic Oncology, Royal Hobart Hospital, Hobart, TAS, Australia. 4. Department of Gynaecological Oncology, Westmead Hospital, University of Sydney, Sydney, NSW, Australia. 5. Department of Medical Oncology, Prince of Wales Hospital, Sydney, NSW, Australia. 6. School of Women's and Infants' Health, University of Western Australia, Perth, WA, Australia. 7. Department of Gynaecological Oncology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia. 8. Department of Gynaecological Oncology, Royal Adelaide Hospital, Adelaide, SA, Australia. 9. Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia. 10. Border Medical Oncology, Wodonga, NSW, Australia.
Abstract
OBJECTIVE: To describe survival patterns in a nationally complete cohort of Australian women with epithelial ovarian cancer, by sociodemographic and clinical factors. DESIGN, SETTING AND PARTICIPANTS: All 1192 women diagnosed with invasive epithelial ovarian cancer in 2005 were identified through state-based cancer registries. We obtained detailed information from their medical records in 2009 and updated survival data in 2012. MAIN OUTCOME MEASURES: Crude 3-year, 5-year and 7-year survival rates; 3-year and 5-year conditional survival; and hazard ratios (HRs) for the association of participant and cancer characteristics with survival, from multivariable Cox proportional hazards models. RESULTS: Overall crude 5-year survival was 35% (95% CI, 33%-38%). Conditional survival increased moderately for women who lived beyond a year from diagnosis, although for women alive 2 years after diagnosis, the probability of surviving a further 5 years was still only 53% (95% CI, 49%-57%). Increasing age and disease stage were most strongly associated with poor survival. After adjusting for these, survival was significantly worse for women with carcinosarcomas (HRadj, 2.1 [95% CI, 1.3-3.2]), clear cell (HRadj, 1.7 [95% CI, 1.2-2.3]) and mucinous (HRadj, 2.6 [95% CI, 1.6-4.0]) cancers than for women with serous cancers. Presence of ascites at diagnosis (HRadj, 1.5 [95% CI, 1.3-1.8]), Charlson comorbidity score ≥ 3 (HRadj, 1.5 [95% CI, 1.1-2.1]), relative socioeconomic disadvantage (HRadj, 1.2 [95% CI, 1.1-1.4]) and regional-remote residence (HRadj, 1.2 [95% CI, 1.0-1.4]) were also associated with poorer survival. CONCLUSIONS: Along with expected adverse effects of age and stage, we found survival differences by histological subtype, presence of ascites and comorbidities. Whether geographic and socioeconomic differences relate to treatment access or other factors warrants further investigation. Conditional survival estimates confirm the ongoing poor long-term prognosis for women with ovarian cancer, reinforcing the need for prevention and better treatments.
OBJECTIVE: To describe survival patterns in a nationally complete cohort of Australian women with epithelial ovarian cancer, by sociodemographic and clinical factors. DESIGN, SETTING AND PARTICIPANTS: All 1192 women diagnosed with invasive epithelial ovarian cancer in 2005 were identified through state-based cancer registries. We obtained detailed information from their medical records in 2009 and updated survival data in 2012. MAIN OUTCOME MEASURES: Crude 3-year, 5-year and 7-year survival rates; 3-year and 5-year conditional survival; and hazard ratios (HRs) for the association of participant and cancer characteristics with survival, from multivariable Cox proportional hazards models. RESULTS: Overall crude 5-year survival was 35% (95% CI, 33%-38%). Conditional survival increased moderately for women who lived beyond a year from diagnosis, although for women alive 2 years after diagnosis, the probability of surviving a further 5 years was still only 53% (95% CI, 49%-57%). Increasing age and disease stage were most strongly associated with poor survival. After adjusting for these, survival was significantly worse for women with carcinosarcomas (HRadj, 2.1 [95% CI, 1.3-3.2]), clear cell (HRadj, 1.7 [95% CI, 1.2-2.3]) and mucinous (HRadj, 2.6 [95% CI, 1.6-4.0]) cancers than for women with serous cancers. Presence of ascites at diagnosis (HRadj, 1.5 [95% CI, 1.3-1.8]), Charlson comorbidity score ≥ 3 (HRadj, 1.5 [95% CI, 1.1-2.1]), relative socioeconomic disadvantage (HRadj, 1.2 [95% CI, 1.1-1.4]) and regional-remote residence (HRadj, 1.2 [95% CI, 1.0-1.4]) were also associated with poorer survival. CONCLUSIONS: Along with expected adverse effects of age and stage, we found survival differences by histological subtype, presence of ascites and comorbidities. Whether geographic and socioeconomic differences relate to treatment access or other factors warrants further investigation. Conditional survival estimates confirm the ongoing poor long-term prognosis for women with ovarian cancer, reinforcing the need for prevention and better treatments.
Authors: Kate Gersekowski; Rachel Delahunty; Kathryn Alsop; Ellen L Goode; Julie M Cunningham; Stacey J Winham; Paul Pharoah; Honglin Song; Susan Jordan; Sian Fereday; Anna DeFazio; Michael Friedlander; Andreas Obermair; Penelope M Webb Journal: Gynecol Oncol Date: 2022-04-07 Impact factor: 5.304
Authors: Camilla Præstegaard; Susanne K Kjaer; Thor S S Nielsen; Signe M Jensen; Penelope M Webb; Christina M Nagle; Estrid Høgdall; Harvey A Risch; Mary Anne Rossing; Jennifer A Doherty; Kristine G Wicklund; Marc T Goodman; Francesmary Modugno; Kirsten Moysich; Roberta B Ness; Robert P Edwards; Ellen L Goode; Stacey J Winham; Brooke L Fridley; Daniel W Cramer; Kathryn L Terry; Joellen M Schildkraut; Andrew Berchuck; Elisa V Bandera; Lisa Paddock; Lambertus A Kiemeney; Leon F Massuger; Nicolas Wentzensen; Paul Pharoah; Honglin Song; Alice S Whittemore; Valerie McGuire; Weiva Sieh; Joseph Rothstein; Hoda Anton-Culver; Argyrios Ziogas; Usha Menon; Simon A Gayther; Susan J Ramus; Aleksandra Gentry-Maharaj; Anna H Wu; Celeste L Pearce; Malcolm C Pike; Alice W Lee; Jenny Chang-Claude; Allan Jensen Journal: Cancer Epidemiol Date: 2016-02-03 Impact factor: 2.984
Authors: Caryn E Peterson; Garth H Rauscher; Timothy P Johnson; Carolyn V Kirschner; Sally Freels; Richard E Barrett; Seijeoung Kim; Marian L Fitzgibbon; Charlotte E Joslin; Faith G Davis Journal: Front Public Health Date: 2015-01-22