Survival of Australian women with Epithelial Ovarian Cancer – a Population-based Study (#71)
Aims: Long term survival for epithelial ovarian cancer is poor; however, available national statistics provide only limited information about factors associated with variation in survival amongst Australian women with the disease. This study aims to describe survival patterns by demographic, clinical and histopathological features in a large, nationally-representative cohort of women with epithelial ovarian cancer.
Methods: All women diagnosed with invasive epithelial ovarian cancer in Australia in 2005 (n=1192) were identified through the state-based cancer registries and detailed demographic and clinical information was obtained from their medical records in 2009/10. Updated survival data for the women was provided by the cancer registries in 2012. We calculated crude five-year survival rates and used multivariable Cox proportional hazards models to estimate the effects of demographic and clinical factors at diagnosis on survival.
Results: The crude five-year survival for all patients was 35.4% (95% Confidence Interval (CI): 32.6-38.2). Survival was worse for women aged >70 years (hazard ratio (HR)=2.7, 95%CI: 2.0-3.5 compared to those aged <50 years); women with ascites (HR=1.5, 95%CI: 1.3-1.8 compared to those without; women of lower socioeconomic status (HR=1.3, 95%CI: 1.1-1.5 compared to those of higher status); women from regional and remote areas (HR=1.2, 95%CI: 1.0-1.4 compared to those from major cities); and women with more comorbidities (HR=1.4, 95%CI: 1.1-1.9 compared to those without). Survival decreased as FIGO Stage increased (HR= 10.8, 95%CI: 6.9-16.8 for stage IV versus stage I disease). After adjusting for stage, mucinous and clear cell cancers were associated with poor survival compared to the serous subtype.
Conclusions: Adverse survival was strongly influenced by advanced age and stage of the disease. Histologic subtype, presence of ascites and multiple comorbidities were also important prognostic factors. Whether the regional and socioeconomic differences noted in ovarian cancer survival are related to women’s access to treatment or to other factors warrants further investigation.