abstract
OBJECTIVE:
The
objective of this retrospective descriptive study was to assess overall
survival and disease free survival of patients treated for epithelial
ovarian cancer by a gynaecologic-oncologist in a single Dutch peripheral
teaching hospital and to identify independent prognostic factors.
STUDY DESIGN:
A
retrospective series of
242 patients treated for epithelial ovarian
cancer between 1999 and 2011 at Meander Medical Centre was reviewed.
Data on patient, tumour and treatment characteristics were collected.
Outcomes were overall survival and progression free survival. Data were
analysed using the Kaplan-Meier method, log-rank test and Cox regression
analysis.
RESULTS:
Median
follow-up was 35 months (range 1-203).
Staging procedures were
performed in 81 patients of which 63% were complete. 61% of patients had
advanced stage disease. In 46%, debulking surgery was complete.
Five-year overall survival and progression free survival for all
patients was 52% and 47%, respectively. Multivariate analysis identified
performance status [HR=1.89 and 1.92 for performance status 2, HR=7.01
and 2.69 for performance status 3], FIGO stage [HR=3.59 for stage II,
HR=5.43 and 5.64 for stage III, HR=12.17 and 10.21 for stage IV] and
residual disease after debulking surgery [HR=2.01 and 1.72 for
incomplete debulking] as independent prognostic factors for overall
survival and progression free survival respectively.
CONCLUSION:
Survival
after surgery for epithelial ovarian cancer in this cohort is
comparable to survival in centralised clinics presented in literature.
Partial concentration of cancer care by recruitment of specialised
gynaecologic-oncologists in teaching hospitals might be an alternative
to complete centralisation of epithelial ovarian cancer treatment in
larger cancer centres.
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