Prognostic factors in young ovarian cancer patients: An analysis of four prospective phase III intergroup trials of the AGO Study Group,GINECO and NSGO |
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| Institution: | 2. Sotio a.s., Prague, Czech Republic;3. 2nd Faculty of Medicine and University Hospital Motol, Prague, Czech Republic;4. 3rd Faculty of Medicine and Faculty Hospital Kralovske Vinohrady, Charles University, Prague, Czech Republic;5. Faculty of Medicine and Faculty Hospital in Hradec Kralove, Charles University, Prague, Czech Republic;1. Department of Neurology, Charité — Universitätsmedizin Berlin, Germany;2. Center for Stroke Research, Charité — Universitätsmedizin Berlin, Germany;3. Department for Biostatistics and Clinical Epidemiology, Charité — Universitätsmedizin Berlin, Germany;4. Department of Cardiology, Universitätskliniken des Saarlandes, Homburg/Saar, Germany;5. NeuroCure, Cluster of Excellence, Charité — Universitätsmedizin Berlin, Germany;1. National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA;2. Wisconsin State Laboratory of Hygiene, University of Wisconsin, Madison, WI, USA;3. Newborn Screening and Genetics Program, Association of Public Health Laboratories, Silver Spring, MD, USA;4. Division of Laboratory Sciences, Centers for Disease Control and Prevention (retired), Atlanta, GA, USA |
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| Abstract: | ObjectivesWe evaluated in a large study meta-database of prospectively randomised phase III trials the prognostic factors for progression-free survival (PFS) and overall survival (OS) in patients < and >40 years of age with advanced epithelial ovarian cancer.MethodsA total of 5055 patients of the AGO, GINECO, NSGO intergroup studies AGO-OVAR 3, 5, 7 and 9 were merged to identify 294 patients <40 years and 4761 patients ≥40 years. We conducted survival analyses and Cox proportional hazard regression models and additionally analysed a very homogeneous subcohort of 405 patients with serous epithelial ovarian cancer, excellent performance status, who had received complete macroscopic upfront cytoreduction and ≥5 chemotherapy cycles.ResultsFor patients <40 years, the median PFS was 28.9 months and the median OS was 75.3 months, while the median PFS for patients ≥40 years was 18.1 months and the median OS was 45.7 months. Independent prognostic factors were similar in both age groups. In a multivariate analysis including prognostic factors potentially leading to confounding, young age appeared to improve PFS (hazard ratio HR], 0.86; 95% confidence interval CI]: 0.72–1.03) and OS (HR, 0.73; 95% CI: 0.59–0.91). The observed effect was even stronger in the subcohort of optimally treated patients with SEOC: PFS (HR, 0.34; 95% CI: 0.19–0.59) and OS (HR, 0.23; 95% CI: 0.09–0.56).DiscussionPrognostic factors were similar in both age groups. Young age appeared a strong independent protective prognostic factor for PFS and OS in the subcohort. |
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| Keywords: | Ovarian cancer Younger patients Prognostic factors |
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