Prognostic factors and overall survival among patients with ovarian cancer in the pre-PARP inhibitor era: the OCRWE-Finland study

• Published in: Acta oncologica 2024-10, Vol.63 (1), p.763-771
• Main Authors: Lahelma, Mari, Rauhamaa, Heini, Leskelä, Riikka-Leena, Isomeri, Outi, Idänpään-Heikkilä, Juhana, Käkelä, Sari, Roebuck, Nichola, Mascialino, Barbara, Hietanen, Sakari, Loukovaara, Mikko, Auranen, Annika
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; bevacizumab; Bevacizumab - therapeutic use; Cohort Studies; Cytoreduction Surgical Procedures; Female; Finland - epidemiology; high-grade serous ovarian cancer; Humans; Middle Aged; neoadjuvant chemotherapy; Neoplasm Staging; Neoplasm, Residual; Original; Ovarian cancer; Ovarian Neoplasms - drug therapy; Ovarian Neoplasms - mortality; Ovarian Neoplasms - pathology; Ovarian Neoplasms - surgery; Ovarian Neoplasms - therapy; overall survival; Poly(ADP-ribose) Polymerase Inhibitors - therapeutic use; Prognosis; real-world evidence; Survival Rate
• ISSN: 1651-226X; 0284-186X; 1651-226X
• DOI: 10.2340/1651-226X.2024.40324

Despite recent treatment advances in ovarian cancer (OC), more real-world evidence studies investigating patient outcomes are needed. OCRWE-Finland was an observational cohort study investigating OC outcomes in Finland during the pre-PARP inhibitor era. Patients were diagnosed with OC between 2014 and 2019 in Finland. This analysis reports baseline characteristics of all patients, patients with high-grade serous OC (HGSOC), and overall survival (OS) for patients with HGSOC. Among 1,711 patients diagnosed with OC, 867 (51%) had HGSOC. The absence versus presence of visible residual disease post-debulking surgery was associated with improved OS for patients at stage III (n = 303; median: NR vs. 43 months; p = 0.005), but not stage IV (n = 118; median: 37 months vs. 40 months; p = 0.96). Bevacizumab treatment at any line at stages III/IV improved OS in the short-term only. Receiving versus not receiving bevacizumab at first-line for patients with visible residual disease post-debulking surgery was associated with improved OS at stage III (median: 48 months vs. 36 months; p = 0.003), but not stage IV (median: 42 months vs. 37 months; p = 0.26). Multivariate Cox regression analyses showed that stage IV at initial diagnosis and the presence of R2 classification post-debulking surgery resulted in poorer OS. In the pre-PARP inhibitor era, the absence versus presence of visible residual disease post-debulking surgery was associated with improved OS in stage III, but not stage IV HGSOC. First-line bevacizumab seemed to be beneficial in patients with stage III HGSOC and visible residual disease.