Improved 5-year disease-free survival for FIGO stage I epithelial ovarian cancer patients without tumor rupture during surgery

T. Paulsen, J. Kærn, C. Tropé

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objective. To investigate the impact of perioperative capsule rupture on disease-free survival (DFS) and cancer-specific survival (CSS) in patients with FIGO stage I epithelial ovarian cancer (EOC I). Methods. This prospective population-based study enrolled all 279 patients with EOC I diagnosed in Norway between 2002 and 2004. All patients underwent primary surgery. The data were collected from notification reports to the Norwegian Cancer Registry and included medical, surgical and histopathological records. Kaplan-Meier plots were used to show differences in DFS and CSS. Cox regression analyses were used to show the effect of prognostic factors on survival, expressed as hazard ratios (HRs). Results. Significantly more patients in the capsule rupture group (Cr group) had clear cell tumors (28%) than in the FIGO stage IA and IB (AB group: 14%) groups, and the FIGO stage IC (C group: 17%; p < 0.05) group. Despite adjuvant chemotherapy (AC), these patients had a poor 5-year DFS, 94% in the non-AC group and 81% in the AC group (p < 0.01). After five years of follow-up, there was a lower DFS among patients in the Cr group (79%) and the C group (81%), compared with patients in the AB group (91%; p < 0.05). Independent prognostic factors at the time of diagnosis were grade, histological type, ascites, adhesions, performance status, CA125 and DNA ploidy. After correcting for the four most important prognostic factors (grade, histological type, ascites, and DNA ploidy), the HR for recurrence was 4.0 (95% CI 1.3-12.7; p < 0.05) for the Cr group and 1.8 (95% CI 0.5-6.1; p = 0.3) for the C group, compared with the AB group. Conclusions. Improvement was observed in the 5-year DFS for EOC I patients without tumor rupture during surgery compared with those with tumor rupture. Since AC did not improve the long-term DFS and CSS rates, it is of utmost importance that surgeons avoid tumor rupture during surgery.

Original languageEnglish (US)
Pages (from-to)83-88
Number of pages6
JournalGynecologic oncology
Volume122
Issue number1
DOIs
StatePublished - Jul 1 2011

Fingerprint

Disease-Free Survival
Rupture
Capsules
Neoplasms
Adjuvant Chemotherapy
Ploidies
Ascites
Survival
Ovarian epithelial cancer
DNA
Norway
Registries
Survival Rate
Regression Analysis
Recurrence
Drug Therapy
Population

Keywords

  • FIGO stage I
  • Ovarian neoplasm
  • Population-based
  • Surgery
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

Cite this

Improved 5-year disease-free survival for FIGO stage I epithelial ovarian cancer patients without tumor rupture during surgery. / Paulsen, T.; Kærn, J.; Tropé, C.

In: Gynecologic oncology, Vol. 122, No. 1, 01.07.2011, p. 83-88.

Research output: Contribution to journalArticle

@article{69980ed2bf27460eb9b1a52178e02326,
title = "Improved 5-year disease-free survival for FIGO stage I epithelial ovarian cancer patients without tumor rupture during surgery",
abstract = "Objective. To investigate the impact of perioperative capsule rupture on disease-free survival (DFS) and cancer-specific survival (CSS) in patients with FIGO stage I epithelial ovarian cancer (EOC I). Methods. This prospective population-based study enrolled all 279 patients with EOC I diagnosed in Norway between 2002 and 2004. All patients underwent primary surgery. The data were collected from notification reports to the Norwegian Cancer Registry and included medical, surgical and histopathological records. Kaplan-Meier plots were used to show differences in DFS and CSS. Cox regression analyses were used to show the effect of prognostic factors on survival, expressed as hazard ratios (HRs). Results. Significantly more patients in the capsule rupture group (Cr group) had clear cell tumors (28{\%}) than in the FIGO stage IA and IB (AB group: 14{\%}) groups, and the FIGO stage IC (C group: 17{\%}; p < 0.05) group. Despite adjuvant chemotherapy (AC), these patients had a poor 5-year DFS, 94{\%} in the non-AC group and 81{\%} in the AC group (p < 0.01). After five years of follow-up, there was a lower DFS among patients in the Cr group (79{\%}) and the C group (81{\%}), compared with patients in the AB group (91{\%}; p < 0.05). Independent prognostic factors at the time of diagnosis were grade, histological type, ascites, adhesions, performance status, CA125 and DNA ploidy. After correcting for the four most important prognostic factors (grade, histological type, ascites, and DNA ploidy), the HR for recurrence was 4.0 (95{\%} CI 1.3-12.7; p < 0.05) for the Cr group and 1.8 (95{\%} CI 0.5-6.1; p = 0.3) for the C group, compared with the AB group. Conclusions. Improvement was observed in the 5-year DFS for EOC I patients without tumor rupture during surgery compared with those with tumor rupture. Since AC did not improve the long-term DFS and CSS rates, it is of utmost importance that surgeons avoid tumor rupture during surgery.",
keywords = "FIGO stage I, Ovarian neoplasm, Population-based, Surgery, Survival",
author = "T. Paulsen and J. K{\ae}rn and C. Trop{\'e}",
year = "2011",
month = "7",
day = "1",
doi = "10.1016/j.ygyno.2011.02.038",
language = "English (US)",
volume = "122",
pages = "83--88",
journal = "Gynecologic Oncology",
issn = "0090-8258",
publisher = "Academic Press Inc.",
number = "1",

}

TY - JOUR

T1 - Improved 5-year disease-free survival for FIGO stage I epithelial ovarian cancer patients without tumor rupture during surgery

AU - Paulsen, T.

AU - Kærn, J.

AU - Tropé, C.

PY - 2011/7/1

Y1 - 2011/7/1

N2 - Objective. To investigate the impact of perioperative capsule rupture on disease-free survival (DFS) and cancer-specific survival (CSS) in patients with FIGO stage I epithelial ovarian cancer (EOC I). Methods. This prospective population-based study enrolled all 279 patients with EOC I diagnosed in Norway between 2002 and 2004. All patients underwent primary surgery. The data were collected from notification reports to the Norwegian Cancer Registry and included medical, surgical and histopathological records. Kaplan-Meier plots were used to show differences in DFS and CSS. Cox regression analyses were used to show the effect of prognostic factors on survival, expressed as hazard ratios (HRs). Results. Significantly more patients in the capsule rupture group (Cr group) had clear cell tumors (28%) than in the FIGO stage IA and IB (AB group: 14%) groups, and the FIGO stage IC (C group: 17%; p < 0.05) group. Despite adjuvant chemotherapy (AC), these patients had a poor 5-year DFS, 94% in the non-AC group and 81% in the AC group (p < 0.01). After five years of follow-up, there was a lower DFS among patients in the Cr group (79%) and the C group (81%), compared with patients in the AB group (91%; p < 0.05). Independent prognostic factors at the time of diagnosis were grade, histological type, ascites, adhesions, performance status, CA125 and DNA ploidy. After correcting for the four most important prognostic factors (grade, histological type, ascites, and DNA ploidy), the HR for recurrence was 4.0 (95% CI 1.3-12.7; p < 0.05) for the Cr group and 1.8 (95% CI 0.5-6.1; p = 0.3) for the C group, compared with the AB group. Conclusions. Improvement was observed in the 5-year DFS for EOC I patients without tumor rupture during surgery compared with those with tumor rupture. Since AC did not improve the long-term DFS and CSS rates, it is of utmost importance that surgeons avoid tumor rupture during surgery.

AB - Objective. To investigate the impact of perioperative capsule rupture on disease-free survival (DFS) and cancer-specific survival (CSS) in patients with FIGO stage I epithelial ovarian cancer (EOC I). Methods. This prospective population-based study enrolled all 279 patients with EOC I diagnosed in Norway between 2002 and 2004. All patients underwent primary surgery. The data were collected from notification reports to the Norwegian Cancer Registry and included medical, surgical and histopathological records. Kaplan-Meier plots were used to show differences in DFS and CSS. Cox regression analyses were used to show the effect of prognostic factors on survival, expressed as hazard ratios (HRs). Results. Significantly more patients in the capsule rupture group (Cr group) had clear cell tumors (28%) than in the FIGO stage IA and IB (AB group: 14%) groups, and the FIGO stage IC (C group: 17%; p < 0.05) group. Despite adjuvant chemotherapy (AC), these patients had a poor 5-year DFS, 94% in the non-AC group and 81% in the AC group (p < 0.01). After five years of follow-up, there was a lower DFS among patients in the Cr group (79%) and the C group (81%), compared with patients in the AB group (91%; p < 0.05). Independent prognostic factors at the time of diagnosis were grade, histological type, ascites, adhesions, performance status, CA125 and DNA ploidy. After correcting for the four most important prognostic factors (grade, histological type, ascites, and DNA ploidy), the HR for recurrence was 4.0 (95% CI 1.3-12.7; p < 0.05) for the Cr group and 1.8 (95% CI 0.5-6.1; p = 0.3) for the C group, compared with the AB group. Conclusions. Improvement was observed in the 5-year DFS for EOC I patients without tumor rupture during surgery compared with those with tumor rupture. Since AC did not improve the long-term DFS and CSS rates, it is of utmost importance that surgeons avoid tumor rupture during surgery.

KW - FIGO stage I

KW - Ovarian neoplasm

KW - Population-based

KW - Surgery

KW - Survival

UR - http://www.scopus.com/inward/record.url?scp=79957702442&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79957702442&partnerID=8YFLogxK

U2 - 10.1016/j.ygyno.2011.02.038

DO - 10.1016/j.ygyno.2011.02.038

M3 - Article

C2 - 21435701

AN - SCOPUS:79957702442

VL - 122

SP - 83

EP - 88

JO - Gynecologic Oncology

JF - Gynecologic Oncology

SN - 0090-8258

IS - 1

ER -