No improvement in long-term survival for epithelial ovarian cancer patients: A population-based study between 1989 and 2014 in the Netherlands. (January 2018)

• Record Type: Journal Article
• Authors: Timmermans, M.; Sonke, G.S.; Van de Vijver, K.K.; van der Aa, M.A.; Kruitwagen, R.F.P.M.
• Is Part Of: European journal of cancer. Volume 88(2018)
• Page Start: 31
• Page End: 37
• Publication Date: 2018-01
• Subjects: Epithelial ovarian cancer -- Surgery -- Chemotherapy -- Overall survival; Cancer -- Periodicals; Neoplasms -- Periodicals; Cancer -- Périodiques; Cancer; Tumors; Electronic journals; Periodicals; Electronic journals; 616.994
• DOI: 10.1016/j.ejca.2017.10.030
• Languages: English
• ISSNs: 0959-8049

Abstract

Abstract: Aim: This study investigates changes in therapy and long-term survival for patients with epithelial ovarian cancer (EOC) in the Netherlands. Methods: All patients with EOC, including peritoneal and fallopian tube carcinoma, diagnosed in the Netherlands between 1989 and 2014 were selected from the Netherlands Cancer Registry. Changes in therapy were studied and related to overall survival (OS) using multivariable Cox regression models. Results: A total of 32, 540 patients were diagnosed with EOC of whom 22, 047 (68%) had advanced stage disease. In early stage, lymph node dissection as part of surgical staging procedures increased over time from 4% in 1989–1993 to 62% in 2009–2014 ( P < 0.001). In advanced stage, the number of patients receiving optimal treatment with surgery and chemotherapy increased from 55% in 1989–1993 to 67% in 2009–2014 ( P < 0.001). Five-year survival rates improved in both early stage (74% versus 79%) and advanced stage (16% versus 24%) as well as in all patients combined (31% versus 34%). Ten-year survival rates, however, slightly improved in early stage (62% versus 67%) and advanced stage (10% versus 13%) but remained essentially unchanged at 24% for all patients combined. Conclusion: Despite intensified treatment and staging procedures, long-term survival for women with EOC has not improved in the last 25 years. The observed improvements in 5-year OS reflect a more prolonged disease control rather than better chances for cure. Furthermore, the apparent better long-term outcome, when early and advanced stage patients are analysed separately, is largely due to improved staging procedures and the ensuing stage migration. These effects disappear in a combined analysis of all patients. Highlights: Treatment and staging procedures were intensified for all patients with epithelial ovarian cancer. Still long-term overall survival has not improved in the last 25 years. Observed improvements in 5-year overall survival reflect more prolonged disease control rather than better chances for cure.