Prognostic factors for women with Stage 1 ovarian cancer with or without adhesions.
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OBJECTIVE: To identify those prognostic factors in women with Stage 1 epithelial ovarian cancer that predict survival. METHODS: A population-based cohort study was conducted which included all newly diagnosed ovarian cancer patients treated initially with surgery from 1996-1998 in Ontario, Canada (N = 1,341). We abstracted charts from hospitals and cancer centres and used hospital and billing claims databases. Cox survival analysis was used to model the association between prognostic factors (including patient characteristics, surgical findings, pathologic findings and subsequent treatment) and survival for those with Stage 1 ovarian cancer. RESULTS: 327 women had Stage 1 or 2 ovarian cancer (where Stage 2 was based on adhesions alone). Prognostic factors that had significant, unadjusted, association with survival were patient age, presence or absence of adhesions, grade, and surface involvement. The multivariable model that best described survival included premenopausal age group (HR 0.32, 95% CI, 0.18-0.55), poor differentiation (HR 2.17, 95% CI, 1.33-3.51), and surface capsule involvement (HR 2.97, 95% CI, 1.59-5.55). A lack of influence of treatment modality stands in contrast to the literature. CONCLUSIONS: Our dataset confirmed that poor grade and surface capsule involvement are poor prognostic factors. Adjuvant therapy did not confer an improved outcome; however, it was likely used in only those patients with poor prognostic indicators and so improved their survival to that of women with good prognostic factors who received surgery alone.
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