Analysis of the survival rate of patients with ovarian cancer of stages I–IV: A retrospective study

Aim. To determine the overall survival (OS) and progression-free survival (PFS) rates of patients with ovarian cancer (OC) of stages I–IV, depending on a number of clinical and morphological factors: age, stage of the disease, histological type of tumor, mutations in the BRCA1/2 genes.

Materials and methods. A retrospective analysis of the medical records of 910 patients with OC of stages I–IV who received treatment in the period from 2004–2021 on the basis of the Primorsky Regional Oncological Dispensary was carried out. Data processing, calculations of indicators of OS and time to progression, median life expectancy and PFS, preparation of graphic material were carried out using the Microsoft Excel 2019 and IBM SPSS Statistics 26 software package in the Windows 11 operating system environment. The Kaplan–Meier method was used, the evaluation of Cox proportional hazard models (single-factor) with the calculation of relative risks and 95% confidence interval. The significance of the coefficients of the model was estimated by the Wald criterion.

Results. It has been shown that the age, stage of OC and BRCA status of patients are important clinical and morphological factors determining survival rates and time without tumor progression. The highest rates of OS and PFS were demonstrated by young patients under 50 years of age with stage I–II OC, patients with low-grade serous carcinoma and serous carcinoma without indicating the degree of malignancy. Patients with a mutation in the BRCA1/2 genes had an advantage in terms of OS compared to patients without mutations. The maximum OS and PFS were in patients under 50 years of age, the median OS was 146.0±27.3, the 5-year-old OS was 76.4±2.8% and the median time to progression was 67.0±9.9 months, the 5-year-old PFS was 53.0±3.2%, respectively. In the analysis of survival depending on the histological structure of the tumor, advantages were noted in patients with low-grade serous carcinoma, median pancreas was 143.0±20.5 months, 5-year OS reached 70.2±4.4%, compared with patients with high-grade serous ovarian carcinoma, median pancreas was 70.0±5.5 months, 5-year OS – 55.5±2.7%. Also, benefits in overall survival were observed in patients with BRCA-associated OC, the median pancreas was 82.0±13.8 months versus 58.0±9.0 months in BRCA1/2-negative patients.

Conclusion. In patients with OC of stages I–IV, the median life expectancy was 87.0±6.59 months, five-year overall survival was 61.8±2.0%; median time to progression was 31.0±2.76 months, five-year PFS was 41.5±2.0%. The survival rate of patients consistently worsens with increasing age and stage of OC, reaching a maximum in patients aged 71 years and older and in patients with stage III–IV. The histological type of tumor causes significant differences in OS and PFS in patients with OC. The lowest rates of survival and PFS are inherent in mucinous carcinoma, clear cell OC, and high-grade serous ovarian carcinoma. The benefits are noted in patients with low-grade serous ovarian carcinoma and serous carcinoma without indicating the degree of malignancy. Patients with BRCA-associated OC had significant benefits in overall survival, while there were no significant differences in PFS.