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The prediction of progression‐free and overall survival in women with an advanced stage of epithelial ovarian carcinoma
Author(s) -
Gerestein CG,
Eijkemans MJC,
de Jong D,
van der Burg MEL,
Dykgraaf RHM,
Kooi GS,
Baalbergen A,
Burger CW,
Ansink AC
Publication year - 2009
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2008.02033.x
Subject(s) - medicine , stage (stratigraphy) , nomogram , ovarian cancer , oncology , gynecologic oncology , hazard ratio , proportional hazards model , progression free survival , ovarian carcinoma , population , gynecology , chemotherapy , cancer , confidence interval , paleontology , environmental health , biology
Objective Prognosis in women with ovarian cancer mainly depends on International Federation of Gynecology and Obstetrics stage and the ability to perform optimal cytoreductive surgery. Since ovarian cancer has a heterogeneous presentation and clinical course, predicting progression‐free survival (PFS) and overall survival (OS) in the individual patient is difficult. The objective of this study was to determine predictors of PFS and OS in women with advanced stage epithelial ovarian cancer (EOC) after primary cytoreductive surgery and first‐line platinum‐based chemotherapy. Design Retrospective observational study. Setting Two teaching hospitals and one university hospital in the south‐western part of the Netherlands. Population Women with advanced stage EOC. Methods All women who underwent primary cytoreductive surgery for advanced stage EOC followed by first‐line platinum‐based chemotherapy between January 1998 and October 2004 were identified. To investigate independent predictors of PFS and OS, a Cox’ proportional hazard model was used. Nomograms were generated with the identified predictive parameters. Main outcome measures The primary outcome measure was OS and the secondary outcome measures were response and PFS. Results A total of 118 women entered the study protocol. Median PFS and OS were 15 and 44 months, respectively. Preoperative platelet count ( P = 0.007), and residual disease <1 cm ( P = 0.004) predicted PFS with a optimism corrected c‐statistic of 0.63. Predictive parameters for OS were preoperative haemoglobin serum concentration ( P = 0.012), preoperative platelet counts ( P = 0.031) and residual disease <1 cm ( P = 0.028) with a optimism corrected c‐statistic of 0.67. Conclusion PFS could be predicted by postoperative residual disease and preoperative platelet counts, whereas residual disease, preoperative platelet counts and preoperative haemoglobin serum concentration were predictive for OS. The proposed nomograms need to be externally validated.