Abstract DP-004: DESCRIBING THE ODDS OF LONG-TERM SURVIVAL AMONG WOMEN DIAGNOSED WITH HIGH-GRADE SEROUS OVARIAN CANCER USING ELECTRONIC MEDICAL RECORDS
Authors: Christina L. Clarke, Lawrence H. Kushi, Jessica Chubak, Pamala A. Pawloski, Joanna E. Bulkley, Mara M. Epstein, Andrea N. Burnett-Hartman, Bethan Powell, C. Leigh Pearce, Heather Spencer Feigelson
Journal: Clinical Cancer Research (2019)

Abstract Relatively little is known about factors associated with long-term survival (LTS) following a diagnosis of ovarian cancer. We conducted a retrospective observational study of high-grade serous ovarian cancer (HGSOC) to explore predictors of LTS, defined as &amp;gt;= 7 years of survivorship, using data from five participating health plans in the Cancer Research Network (CRN, http:\\crn.cancer.gov). Our primary data source was the Virtual Data Warehouse (VDW), a common data model which includes standardized, individual-level data extracted from the electronic data systems of each study site. We included 642 women with incident HGSOC diagnosed between 2000 and 2008 to allow for at least 7 years of follow-up. We conducted a multivariable logistic regression analysis to compare characteristics of women who survived &amp;gt;=7 years after diagnosis (n=148) to those who died within 7 years of diagnosis (n=494). In addition to stage and grade, predictors considered for the model included age, race, smoking status at time of diagnosis, body mass index (BMI) within the year prior to diagnosis, and CA-125 level prior to cancer treatment. We examined estrogen and hormonal contraceptive use, as well as the prevalence of comorbidities in the year prior to diagnosis of ovarian cancer. We also included variables for receipt of surgery, radiation, and chemotherapy. We used forward selection to include variables, and retained them in the final model if they had a p-value of &amp;lt;= 0.3. Our final model included CRN study site, age, stage at diagnosis, CA-125 (categorized as &amp;lt;35 or &amp;gt;=35 units/ml), Charlson comorbidity score, receipt of chemotherapy, BMI, and five separate comorbid conditions: weight loss, hypothyroidism, liver disease, chronic pulmonary disease and hypertension. Of these, only younger age, lower stage, and receipt of chemotherapy were statistically significantly associated with LTS. The OR for LTS was 2.9 (95% CI: 1.2-6.3) for ages 18-49 years at diagnosis compared to &amp;gt;=70 years of age. Those who were diagnosed at stage IV had statistically significantly lower odds of surviving &amp;gt;=7 years than any other stage of disease. The OR for LTS for stage I vs. stage IV was 46.6 (95% CI: 46.7 – 15.9), stage II vs. stage IV was 14.1 (95% CI: 5.3-37.0) and stage III vs. stage IV was 5.3 (95% CI: 2.7-10.4). The OR was 2.9 (95% CI: 1.0-8.4) for receipt of chemotherapy versus no chemotherapy after adjusting for all other covariates. Our analysis of data from electronic medical records did not identify any new characteristics that may be associated with ovarian cancer LTS. Citation Format: Christina L. Clarke, Lawrence H. Kushi, Jessica Chubak, Pamala A. Pawloski, Joanna E. Bulkley, Mara M. Epstein, Andrea N. Burnett-Hartman, Bethan Powell, C. Leigh Pearce, Heather Spencer Feigelson. DESCRIBING THE ODDS OF LONG-TERM SURVIVAL AMONG WOMEN DIAGNOSED WITH HIGH-GRADE SEROUS OVARIAN CANCER USING ELECTRONIC MEDICAL RECORDS [abstract]. In: Proceedings of the 12th Biennial Ovarian Cancer Research Symposium; Sep 13-15, 2018; Seattle, WA. Philadelphia (PA): AACR; Clin Cancer Res 2019;25(22 Suppl):Abstract nr DP-004.