Skip to main content Skip to main navigation menu Skip to site footer

Correlation between clinicopathological factors and clinical outcomes of recurrent epithelial ovarian cancer at a tertiary hospital in Surabaya, Indonesia

  • Adityo Prabowo ,
  • Brahmana Askandar Tjokroprawiro ,
  • Budi Utomo ,


Abstract

Introduction:  Ovarian cancer is one of the leading causes of cancer death in women globally. The objective of this study was to determine the correlation and the association between age, stage, histopathology, grade, ascites, tumor residual, CA-125 level, and type of surgery on recurrence, disease-free survival, overall survival and mortality of epithelial ovarian cancer patients.

Methods: An analytical retrospective study using medical records and interviews of epithelial ovarian cancer patients was conducted in Dr. Soetomo Hospital. The study included the data from January 2016-December 2020. Kaplan-Meier and log-rank test were used to assess the factors associated with disease-free survival (DFS) and overall survival (OS).

Results: A total of 358 patients with epithelial ovarian cancer from 2016 to 2020 were included in the study of which 153 of recurrence cases. Clinicopathological factors that correlated with disease-free survival were stage, histopathology, grade, ascites, tumor residual, CA-125, and type of surgery (p<0.05). The factors that correlated with overall survival were stage, histopathology, grade, ascites, residual tumor, and CA-125 value (p<0.05). The most significant factors associated with recurrence and mortality were stage, grade, and ascites. Stage II and III had an HR (hazard ratio) of 1.9 and 2.1 for recurrence compared to stage I, respectively. Grade II and III patients had HRs of 2.1, and 3.4 for recurrence compared to stage I, respectively. The presence of ascites had an HR of 1.5 compared to those had no ascites. Stage III had an HR of 1.9 for mortality compared to stage I, respectively. Grade II and III patients had HRs of 3.6, and 5.0 for death compared to stage I, respectively. The presence of ascites had an HR of 1.6 compared to patients with no ascites. Compared to serous type, those patients with mucinous and clear cell had HR of 1.8 and 3.1 for mortality, respectively

Conclusion: Stage, grade, and ascites were the most significant factors in the incidence of recurrence and mortality of epithelial ovarian cancer.

Keywords: Disease-free survival epithelial ovarian cancer recurrence ovarian cancer

References

  1. Andrea CV, Ucella S, Sozzi G, Cecarroni, Mautone D, Armano G, Franchi M, Chiantera V, Berretta R. Primary site disease and recurrence location in ovarian cancer patients undergoing primary debulking surgery vs interval debulking surgery. Eur J Surg Oncol. 2021;47:1075-1082.
  2. Mulawardhana P, Hartono P, Nugroho H, Ayuningtyas A. Death of 43 Indonesian women with ovarian cancer: A case series. Int J Surg Case Rep. 2021;78:391-396.
  3. Kim SI, Lee EJ, Lee M, Chung H, Kim JW, Park NH, Song YS, Kim HS. Recurrence patterns after bevacizumab in platinum-sensitive, recurrent epithelial ovarian cancer. Int J Gynecol Cancer. 2020;30(12):1943-1950.
  4. Ushijima K. Treatment for recurrent ovarian cancer-at first relapse. J Oncol. 2010;429-497.
  5. Ferrandina G, Legge F, Salutari V, Paglia A, Testa A, Scambia G. Impact of pattern of recurrence on clinical outcome of ovarian cancer patients: clinical considerations. Eur J Cancer. 2006;42:2296-2302.
  6. Hogen L, Vicus D, Ferguson SE, Gien LT, Mozes SN, Lennox GK, Bernardini MQ. Patterns of recurrence and impact on survival in patients with clear cell ovarian carcinoma. Int J Gynecol Cancer. 2019;29:1164-1169.
  7. Vidal F, Guerby P, Luyckx M, Haddad P, Stoeckle E, Morice P, Leblanc E, Lecuru F, Darai E, Classe JM, Pomel C, Filleron T, Ferron G, Querieu D, Rafii A. Are early relapses in advanced-stage ovarian cancer doomed to a poor prognosis?. PLOS One. 2016;11(1):e0147787.
  8. Chan JK, Tian C, Monk BJ, Herzog T, Kapp DS, Bell J, Young RC. Prognostic factors for high-risk early-stage epithelial ovarian cancer. Cancer. 2008;112(10):2202-2210.
  9. Savescu A, Balescu I, Bacalbasa N. Prognostic factors for secondary cytoreductive surgery in recurrent ovarian cancer. Obstet Gynecol Cases Rev. 2019;6:147-152.
  10. Klar M, Hasenburg A, Hasanov M, Hilpert F, Meier W, Pfisterer J, Pudjane-Lauraine E, Herrstedt J, Reuss A, du Bois A. Prognostic factors in young ovarian cancer patients: An analysis of four prospective phase III intergroup trials of the AGO study group, GINECO and NSGO. Eur J Cancer. 2016;66:114-124.
  11. Tognon G, Carnazza M, Ragnoli M, Calza S, Ferrari F, Gambino A, Zizioli V, Notaro S, Sostegni B, Sartori E. Prognostic factors in early-stage ovarian cancer. Ecancermedicalscience. 2013;7:325-332.
  12. Chang LC, Huang CF, Lai MS, Shen LJ, Wu FLL, Cheng WF. Prognostic factors in epithelial ovarian cancer: a population-based study. PLos One. 2018;13(3):e0194993.
  13. Ezzati M, Abdullah A, Shariftabrizi A, Hou J, Kopf M, Stedman JK, Samuelson R, Shahabi, S. Recent advancements in prognostic factors of epithelial ovarian carcinoma. Int Sch Res Notices. 2014; D953509.
  14. Kang JH, Lai YL, Cheng WF, Kim HS, Kuo KT, Chen YL, Lee YY. Clinical Factors associated with prognosis in low-grade serous ovarian carcinoma: experiences at two large academic institutions in Korea and Taiwan. Scientific reports. 2020;10:200-212.
  15. Ford CE, Werner B. The untapped potential of ascites in ovarian cancer research and treatment. Br J Cancer. 2020;123:9-16.
  16. Kipps E, Tan DSP, Kaye SB. Meeting the challenge of ascites in ovarian cancer: new avenues for therapy and research. Nat Rev Cancer. 2013;13(4):273-282.
  17. Damayanti IN, Yulianti I, Kusumastuti EH. Three years survival rate of epithelial ovarian cancer patients in Dr. Kariadi Hospital, Semarang, Central Java. Majalah Obstetri Ginekologi. 2018;24(3):100–104.
  18. Azizah F, Mulawardhana P, Sandhika W. Association of age at menarche, parity, and hormonal contraceptive use with the histologic type of ovarian cancer. Gynecology Obstetrics Magazine. 2021;29(3):18–123.
  19. Tjokroprawiro BA, Sari, NK, Yuliati I, Mardiyana L. Characteristics of suspected malignant ovarian tumor patients who performed surgery at Tertiary Referral Hospital. Systematic Reviews in Pharmacy, 2020;11(5):181–184.
  20. Mulawardhana P, Hartono P, Nugroho H, Ayuningtyas A. Death of 43 Indonesian women with ovarian cancer: A case series. Int J Surg Case Rep. 2021;78:391–396.
  21. Yoshihara M, Emoto R, Kitami K, Iyoshi S, Uno K, Mogi K, Tano S, Yoshikawa S, Matsui S, Kajiyama H. Prognostic aspects of positive ascites cytology and effects of therapeutic interventions in epithelial ovarian cancer: a large-scale multi-institutional study. Scientific Reports. 2021;11:15154.
  22. Paik ES, Lee YY, Shim M, Choi HJ, Kim TJ, Choi CH, Lee JW, Kim BG, Bae DS. Timing and patterns of recurrence in epithelial ovarian cancer patients with no gross residual disease after primary debulking surgery. Aust N Z J Obstet Gynaecol. 2016;56(6):639-647.
  23. Wong OGW, Li J, Cheung ANY. Targeting DNA damage response pathway in ovarian clear cell carcinoma. Front Oncol. 2021;11:666815.
  24. Agarwal R, Kaye SB. Prognostic factors in ovarian cancer: how close are we to a complete picture? Annals of Oncology. 2005;16:4-6.
  25. Purnama A, Mardina V, Puspita K, Qanita I, Rizki DR, Hasballah K, Iqbal M, Sarong M: Molecular docking of two cytotoxic compounds from Calotropis gigantea leaves against therapeutic molecular target of pancreatic cancer. Narra J. 2021;1(2):e37-e43.
  26. Brahmantara BN, Kartha IBM, Budiana ING. Characteristic gynaecology-oncology patients from Obstetrics and Gynaecology Outpatient Clinic Mangusada Regional Hospital Badung reffered to Sanglah Hospital from 1st January 2016 – 31st December 2018. Bali Med J. 2020;9(2):430-436.

How to Cite

Prabowo, A., Tjokroprawiro, B. A. ., & Utomo, B. . (2022). Correlation between clinicopathological factors and clinical outcomes of recurrent epithelial ovarian cancer at a tertiary hospital in Surabaya, Indonesia. Bali Medical Journal, 11(2), 807–812. https://doi.org/10.15562/bmj.v11i2.3575
ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver
Download Citation
Endnote/Zotero/Mendeley (RIS) BibTeX

HTML
0

Total
15

Share

Search Panel

Adityo Prabowo
Google Scholar
Pubmed
BMJ Journal

Brahmana Askandar Tjokroprawiro
Google Scholar
Pubmed
BMJ Journal

Budi Utomo
Google Scholar
Pubmed
BMJ Journal