Exploratory Analysis Of Epidemiological, Clinicopathological Characteristics And Prognostic Factors Of Stage IV Epithelial Ovarian Cancers: A Single Institutional Study In Chennai
Authors: Parai Dr. Shaoni , Ramkumar Dr B. , Raja Dr. G. , Sharma Dr. Manish Kumar , J G Dr. Atul , Narasimman Dr. Vasanth Rooban 
Published: October 2024

Background: Ovarian cancer (oc) is the 3rd most common cancer (ca) in females in India (globocan 2020)1 , epithelial ovarian cancer consists of 90% of all oc. More than 70% of ovarian ca patients diagnosed at advanced stage due to its asymptomatic nature and insidious onset of the disease. Metastases(mets) remained a major cause of mortality in ovarian cancer patients. This study is being undertaken to identify prognostic and predictive factors associated with the survival of patients with metastatic ovarian cancer. Materials and methods: It is a retrospective study. Patients diagnosed with stage IV epithelial ovarian cancer (treatment naive), who attended the department of medical oncology, Govt Royapettah Hospital (GRH), Chennai during 2013- 2018 with regular follow up included. 5 years follow-up data collected till dec, 2023. Aim of this study is to identify the epidemiological, clinicopathological characteristics, treatment outcome and other prognostic factors predicting overall survival (os) and progression free survival (pfs) in patients with stage IV ovarian cancer. Results: In this study 85 patients with stage IV epithelial ovarian ca were analysed. In our study median os is 27 months, pfs is 13 months. Overall survival (os) rate at 2 years (yr)= 0.5647, overall survival (os) rate at 5 years = 0.105. Progression free survival (pfs) rate at 2 years = 0.1765, progression free survival (pfs) rate at 5 years = 0.0471. Kaplan Meier (KM) survival curves have shown response after 1 st line treatment, surgery vs no surgery, platinum sensitive recurrence have significant association with 2 year, 5 year os and pfs (p<0.05). Hpe (high grade serous vs less common ovarian cancers) has showed significant correlation with 5 year survival (p<0.05), univariate cox regression analysis has shown, number of mets (single site vs multiple site) significantly associated with improved 2 year survival (p=0.02) and pfs (p=0.005). Both univariate and multivariate analysis showed age (<=56 vs>56) as independent factor correlating with 5 year survival (p=0.02), (p=0.01), multivariate cox regression analysis showed pretreatment ca 125 is an independent variables for pfs (p=0.04). Conclusion: In our study KM survival curves have shown if patients could undergo cytoreductive surgery, had response after 1 st line treatment (surgery and chemo) , significant improvement in 2 year, 5 year os and pfs can be achieved, though not established in regression analysis. Recurrence rate remained very high in advanced stage, in our study KM survival curve has shown platinum sensitive recurrence has significantly better 2 year, 5 year os and pfs rate. Cox regression analysis showed patients with single site of mets have significantly better 2 year survival and pfs than patients with multiple site of mets. Pre treatment raised ca 125 found to be an independent factor which can predict poor pfs. Higher age is an independent factor found to impact 5 year os