Age and Other Factors Predict Stage III Ovarian Cancer Prognosis

NEW YORK SEPT 05, 2007 (Reuters Health) - Age, performance status and tumor factors independently predict disease progression and death in women with stage III epithelial ovarian cancer, according to a report in the August 20th issue of the Journal of Clinical Oncology.

The small sample size and study population heterogeneity of earlier studies have contributed to conflicting results on prognostic factors for advanced epithelial ovarian cancer, the authors explain.

Dr. G. Larry Maxwell from Walter Reed Army Medical Center, Washington, DC and colleagues investigated independent prognostic factors in nearly 1900 women with stage III invasive epithelial ovarian cancer who participated in six randomized phase III trials using chemotherapy with a platinum agent and paclitaxel following primary surgical cytoreduction.

The median overall progression-free survival was 17.1 months, the authors report, and the median overall survival was 45.3 months.

Older age was independently associated with an increased risk of disease progression and death, with each decade increasing the risk of progression by 6% and the risk of death by 12%.

Similarly, women with a Gynecologic Oncology Group performance status of 1 or 2 had a 12% higher risk of progression and similarly elevated risk of death as women with a performance status of 0.  Greater residual tumor volume was also independently associated with worse progression-free and overall survival, the investigators note.

Compared with serous histology, mucinous and clear-cell histology were associated with a decreased progression-free survival and overall survival, and endometrioid histology was associated with an increased progression-free and overall survival.

These independent prognostic factors are similar to those identified among women receiving earlier standard therapies. "It would appear that the magnitude of improvement in progression-free survival and overall survival provided by the addition of taxanes to adjuvant therapy is not large enough to abrogate the impact of these prognostic factors," the researchers note.

"Although translational research is important in determining whether these results are due to tumor biology and unaffected by improved therapy," the authors conclude, "future study designs might incorporate stratifications based on these independent predictors of progression-free survival and overall survival as has been recommended previously."

SOURCE:

• J Clin Oncol 2007;25:3621-3627.