abstract:
Prognostic factors in young ovarian cancer patients: An analysis of four prospective phase III intergroup trials of the AGO Study Group, GINECO and NSGO
Highlights
- •To detect the effect of young age on survival in ovarian cancer patients.
- •A meta-database analysis of 5055 ovarian cancer patients.
- •Potential confounding and effect measure modification are considered.
- •Prognostic factors of survival are similar in patients under and over 40 years of age.
- •Young age at diagnosis of ovarian cancer improves survival.
Abstract
Objectives
We
evaluated in a large study meta-database of prospectively randomised
phase III trials the prognostic factors for progression-free survival
(PFS) and overall survival (OS) in patients < and >40 years of age
with advanced epithelial ovarian cancer.
Methods
A
total of 5055 patients of the AGO, GINECO, NSGO intergroup studies
AGO-OVAR 3, 5, 7 and 9 were merged to identify 294 patients <40 years
and 4761 patients ≥40 years. We conducted survival analyses and Cox
proportional hazard regression models and additionally analysed a very
homogeneous subcohort of 405 patients with serous epithelial ovarian
cancer, excellent performance status, who had received complete
macroscopic upfront cytoreduction and ≥5 chemotherapy cycles.
Results
For
patients <40 years, the median PFS was 28.9 months and the median OS
was 75.3 months, while the median PFS for patients ≥40 years was 18.1
months and the median OS was 45.7 months. Independent prognostic factors
were similar in both age groups. In a multivariate analysis including
prognostic factors potentially leading to confounding, young age
appeared to improve PFS and OS. The
observed effect was even stronger in the subcohort of optimally treated
patients with SEOC: PFS and OS.
Discussion
Prognostic
factors were similar in both age groups. Young age appeared a strong
independent protective prognostic factor for PFS and OS in the
subcohort.
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