Population-based study of survival for women with serous cancer of the ovary, fallopian tube, peritoneum or undesignated origin - on behalf of the Swedish gynecological cancer group (SweGCG)

• Published in: Gynecologic oncology 2017-01, Vol.144 (1), p.167-173
• Main Authors: Dahm-Kähler, Pernilla, Borgfeldt, Christer, Holmberg, Erik, Staf, Christian, Falconer, Henrik, Bjurberg, Maria, Kjölhede, Preben, Rosenberg, Per, Stålberg, Karin, Högberg, Thomas, Åvall-Lundqvist, Elisabeth
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cancer and Oncology; Cancer och onkologi; Cancer origin; carcinoma; Chemotherapy, Adjuvant; Clinical Medicine; Cytoreduction Surgical Procedures; Fallopian Tube Neoplasms - mortality; Fallopian Tube Neoplasms - pathology; Fallopian Tube Neoplasms - therapy; Female; Hematology, Oncology and Palliative Medicine; Humans; Klinisk medicin; Medical and Health Sciences; Medicin och hälsovetenskap; Middle Aged; Neoplasm Grading; Neoplasm Staging; Neoplasm, Residual; Neoplasms, Cystic, Mucinous, and Serous - mortality; Neoplasms, Cystic, Mucinous, and Serous - pathology; Neoplasms, Cystic, Mucinous, and Serous - therapy; Neoplasms, Unknown Primary - mortality; Neoplasms, Unknown Primary - pathology; Neoplasms, Unknown Primary - therapy; Obstetrics & Gynecology; Obstetrics and Gynecology; Obstetrics, Gynecology and Reproductive Medicine; Oncology; Ovarian cancer; Ovarian Neoplasms - mortality; Ovarian Neoplasms - pathology; Ovarian Neoplasms - therapy; Peritoneal Neoplasms - mortality; Peritoneal Neoplasms - pathology; Peritoneal Neoplasms - therapy; Platinum Compounds - therapeutic use; Registries; Reproduktionsmedicin och gynekologi; Serous cancer; Survival; Survival Rate; Sweden - epidemiology; trial; Young Adult
• ISSN: 0090-8258; 1095-6859; 1095-6859
• DOI: 10.1016/j.ygyno.2016.10.039

Abstract Objective The aim of the study was to determine survival outcome in patients with serous cancer in the ovary, fallopian tube, peritoneum and of undesignated origin. Methods Nation-wide population-based study of women ≥ 18 years with histologically verified non-uterine serous cancer, included in the Swedish Quality Registry for primary cancer of the ovary, fallopian tube and peritoneum diagnosed 2009–2013. Relative survival (RS) was estimated using the Ederer II method. Simple and multivariable analyses were estimated by Poisson regression models. Results Of 5627 women identified, 1246 (22%) had borderline tumors and 4381 had malignant tumors. In total, 2359 women had serous cancer; 71% originated in the ovary (OC), 9% in the fallopian tube (FTC), 9% in the peritoneum (PPC) and 11% at an undesignated primary site (UPS). Estimated RS at 5-years was 37%; for FTC 54%, 40% for OC, 34% for PPC and 13% for UPS. In multivariable regression analyses restricted to women who had undergone primary or interval debulking surgery for OC, FTC and PPC, site of origin was not independently associated with survival. Significant associations with worse survival were found for advanced stages (RR 2.63, P < 0.001), moderate (RR 1.90, P < 0.047) and poor differentiation (RR 2.20, P < 0.009), neoadjuvant chemotherapy (RR1.33, P < 0.022), residual tumor (RR 2.65, P < 0.001) and platinum single (2.34, P < 0.001) compared to platinum combination chemotherapy. Conclusion Survival was poorer for serous cancer at UPS than for ovarian, fallopian tube and peritoneal cancer. Serous cancer at UPS needs to be addressed when reporting and comparing survival rates of ovarian cancer.