TY - JOUR
T1 - Evolving population-based statistics for rare epithelial ovarian cancers
AU - Matsuo, Koji
AU - Machida, Hiroko
AU - Matsuzaki, Shinya
AU - Grubbs, Brendan H.
AU - Klar, Maximilian
AU - Roman, Lynda D.
AU - Sood, Anil K.
AU - Gershenson, David M
AU - Wright, Jason D.
N1 - Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2020/4
Y1 - 2020/4
N2 - Objective: To describe how population-based statistics for rare epithelial ovarian cancers are evolving. Methods: This is a retrospective observational study examining the Surveillance, Epidemiology, and End Results Program from 1988 to 2016. Overall survival (OS) of clear cell (OCCC), mucinous (MOC), and low-grade serous (LGSOC) ovarian cancers were compared to high-grade serous ovarian cancer (HGSOC) by fitting a propensity score matching. Results: Among 113,365 ovarian malignancies, 5780 OCCCs (5.1%), 7561 MOCs (6.7%), and 2021 LGSOCs (1.8%) were compared to 38,199 HGSOCs. OCCCs and MOCs were more likely to be diagnosed with stage I disease compared to HGSOC (57.0–59.5% versus 8.6%, P < 0.001). For early-stage disease, OCCC (hazard ratio [HR] 0.91, 95% confidence interval [CI] 0.82–1.01) and MOC (HR 0.94, 95%CI 0.85–1.04) had similar OS to HGSOC whereas LGSOC had superior OS (HR 0.93, 95%CI 0.89–0.97) versus HGSOC. Conversely, for advanced-stage disease, OCCC (HR 1.42, 95%CI 1.32–1.53) and MOC (HR 1.11, 95%CI 1.09–1.13) had poorer OS whereas LGSOC (HR 0.86, 95%CI 0.84–0.89) had superior OS compared to HGSOC. OCCC (HR range, 1.92–2.45) and MOC (HR range, 1.73–2.22) had particularly poorer OS in the first three years following diagnosis compared to HGSOC. Population-level statistics for advanced-stage disease showed that 5-year OS rates have increased in HGSOC (16.9% to 36.8%, P < 0.001) and LGSOC (50.8% to 66.4%, P = 0.010); but remain unchanged for OCCC (21.0% to 28.2%, P = 0.174) and MOC (21.4% to 16.5%, P = 0.102). Conclusion: OCCC, MOC, and LGSOC comprise 2–7% of ovarian malignancies, have distinct characteristics and survival compared to HGSOC. While these rare tumors have a favorable to comparable prognosis in early-stage disease, disproportionally poor survival in advanced-stage OCCC and MOC highlights the need for further research into novel treatment strategies.
AB - Objective: To describe how population-based statistics for rare epithelial ovarian cancers are evolving. Methods: This is a retrospective observational study examining the Surveillance, Epidemiology, and End Results Program from 1988 to 2016. Overall survival (OS) of clear cell (OCCC), mucinous (MOC), and low-grade serous (LGSOC) ovarian cancers were compared to high-grade serous ovarian cancer (HGSOC) by fitting a propensity score matching. Results: Among 113,365 ovarian malignancies, 5780 OCCCs (5.1%), 7561 MOCs (6.7%), and 2021 LGSOCs (1.8%) were compared to 38,199 HGSOCs. OCCCs and MOCs were more likely to be diagnosed with stage I disease compared to HGSOC (57.0–59.5% versus 8.6%, P < 0.001). For early-stage disease, OCCC (hazard ratio [HR] 0.91, 95% confidence interval [CI] 0.82–1.01) and MOC (HR 0.94, 95%CI 0.85–1.04) had similar OS to HGSOC whereas LGSOC had superior OS (HR 0.93, 95%CI 0.89–0.97) versus HGSOC. Conversely, for advanced-stage disease, OCCC (HR 1.42, 95%CI 1.32–1.53) and MOC (HR 1.11, 95%CI 1.09–1.13) had poorer OS whereas LGSOC (HR 0.86, 95%CI 0.84–0.89) had superior OS compared to HGSOC. OCCC (HR range, 1.92–2.45) and MOC (HR range, 1.73–2.22) had particularly poorer OS in the first three years following diagnosis compared to HGSOC. Population-level statistics for advanced-stage disease showed that 5-year OS rates have increased in HGSOC (16.9% to 36.8%, P < 0.001) and LGSOC (50.8% to 66.4%, P = 0.010); but remain unchanged for OCCC (21.0% to 28.2%, P = 0.174) and MOC (21.4% to 16.5%, P = 0.102). Conclusion: OCCC, MOC, and LGSOC comprise 2–7% of ovarian malignancies, have distinct characteristics and survival compared to HGSOC. While these rare tumors have a favorable to comparable prognosis in early-stage disease, disproportionally poor survival in advanced-stage OCCC and MOC highlights the need for further research into novel treatment strategies.
KW - Clear cell
KW - Low-grade serous
KW - Mucinous
KW - Ovarian cancer
KW - Rare tumor
KW - Survival
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U2 - 10.1016/j.ygyno.2019.11.122
DO - 10.1016/j.ygyno.2019.11.122
M3 - Article
C2 - 31954534
AN - SCOPUS:85082412609
SN - 0090-8258
VL - 157
SP - 3
EP - 11
JO - Gynecologic oncology
JF - Gynecologic oncology
IS - 1
ER -