Optimal Tumor Reduction, Platinum Sensitivity Characterize Long-term Ovarian Cancer Survival
Women who are long-term survivors of high-grade serous carcinoma usually have platinum-sensitive disease.
Women who are long-term survivors of high-grade serous carcinoma (HGSC) usually have platinum-sensitive disease and undergo optimal tumor reduction surgery.1 These results were presented at the Society for Gynecologic Oncology's 2016 Annual Meeting on Women's Cancer in San Diego, California.
HGSC is the most common ovarian cancer. It normally presents at an advanced stage with poor prognosis and poor overall survival. This multicenter study was led by Douglas Levine, MD, head of the gynecology research laboratory and associate attending surgeon at Memorial Sloan Kettering Cancer Center in New York, NY.
Researchers examined 203 long-term (≥ 10 years) survivors of HGSC in a multicenter research consortium among 5 academic centers in the United States. This study included women diagnosed with stage III/IV high-grade serous ovarian, fallopian tube, or peritoneal cancer.
Most (72.4%) patients were diagnosed at stage IIIc disease. Median age at diagnosis was 57 years.
Both optimal cytoreduction surgery and platinum sensitivity were present in the majority of long-term survivors. Over 85% (n = 143) of patients who underwent primary cytoreduction surgery had optimal results with residual disease no larger than 1 cm in diameter. Nearly half (46.6%) of patients received a complete gross resection. Still, primary cytoreduction surgery achieved suboptimal results in 24 long-term survivors (14%).
Nearly half of patients (46.8%, n = 88) did not develop recurrent disease after a median follow-up of 12 years. During the follow-up interval, approximately 10% (n = 21) had 1 disease recurrence, approximately 10% (n = 19) had 2 disease recurrences, and over 30% (n = 60) had more than 2 disease recurrences.
Of patients who tested for BRCA1/2 mutations (n = 79), more than half (54.4%, n = 43) were BRCA mutation carriers. Though BRCA mutation carriers usually have favorable ovarian cancer prognosis, the researchers suggested other genetic or biological factors affecting long-term survival as 45.6% of tested patients were not carriers.
“Long-term survivors of advanced HGSC generally have clinical features including optimal surgical cytoreduction and platinum-sensitive disease. The majority of these patients will develop recurrent disease with many being treated with multiple varied therapeutic regimens,” concluded the authors.
“Future work will compare the clinical features of this [long-term] survivor cohort of ‘exceptional' responders with the characteristics of HGSC patients with less favorable outcomes.”
1. Dao F, Schlappe B, Tseng JH, et al. Characteristics of 10-year survivors of high-grade serous ovarian carcinoma. Abstract 147. Presented at the 47th Annual Meeting of the Society of Gynecologic Oncology on March 19-22, 2016, in San Diego, California.