Clinicopathologic characteristics associated with long-term survival in advanced epithelial ovarian cancer: an NRG Oncology/Gynecologic Oncology Group ancillary data study

C. A. Hamilton, A. Miller, Y. Casablanca, N. S. Horowitz, Bunja Jane Rungruang, T. C. Krivak, S. D. Richard, N. Rodriguez, M. J. Birrer, F. J. Backes, M. A. Geller, M. Quinn, M. J. Goodheart, D. G. Mutch, J. J. Kavanagh, G. L. Maxwell, M. A. Bookman

Research output: Contribution to journalArticle

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Abstract

Objective: To identify clinicopathologic factors associated with 10-year overall survival in epithelial ovarian cancer (EOC) and primary peritoneal cancer (PPC), and to develop a predictive model identifying long-term survivors. Methods: Demographic, surgical, and clinicopathologic data were abstracted from GOG 182 records. The association between clinical variables and long-term survival (LTS) (> 10 years) was assessed using multivariable regression analysis. Bootstrap methods were used to develop predictive models from known prognostic clinical factors and predictive accuracy was quantified using optimism-adjusted area under the receiver operating characteristic curve (AUC). Results: The analysis dataset included 3010 evaluable patients, of whom 195 survived greater than ten years. These patients were more likely to have better performance status, endometrioid histology, stage III (rather than stage IV) disease, absence of ascites, less extensive preoperative disease distribution, microscopic disease residual following cyoreduction (R0), and decreased complexity of surgery (p < 0.01). Multivariable regression analysis revealed that lower CA-125 levels, absence of ascites, stage, and R0 were significant independent predictors of LTS. A predictive model created using these variables had an AUC = 0.729, which outperformed any of the individual predictors. Conclusions: The absence of ascites, a low CA-125, stage, and R0 at the time of cytoreduction are factors associated with LTS when controlling for other confounders. An extensively annotated clinicopathologic prediction model for LTS fell short of clinical utility suggesting that prognostic molecular profiles are needed to better predict which patients are likely to be long-term survivors.

Original languageEnglish (US)
Pages (from-to)275-280
Number of pages6
JournalGynecologic Oncology
Volume148
Issue number2
DOIs
StatePublished - Feb 2018

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Survival
Ascites
Area Under Curve
Survivors
Regression Analysis
ROC Curve
Histology
Demography
Ovarian epithelial cancer
Neoplasms

Keywords

  • Long-term survival
  • Ovarian cancer

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

Cite this

Clinicopathologic characteristics associated with long-term survival in advanced epithelial ovarian cancer : an NRG Oncology/Gynecologic Oncology Group ancillary data study. / Hamilton, C. A.; Miller, A.; Casablanca, Y.; Horowitz, N. S.; Rungruang, Bunja Jane; Krivak, T. C.; Richard, S. D.; Rodriguez, N.; Birrer, M. J.; Backes, F. J.; Geller, M. A.; Quinn, M.; Goodheart, M. J.; Mutch, D. G.; Kavanagh, J. J.; Maxwell, G. L.; Bookman, M. A.

In: Gynecologic Oncology, Vol. 148, No. 2, 02.2018, p. 275-280.

Research output: Contribution to journalArticle

Hamilton, CA, Miller, A, Casablanca, Y, Horowitz, NS, Rungruang, BJ, Krivak, TC, Richard, SD, Rodriguez, N, Birrer, MJ, Backes, FJ, Geller, MA, Quinn, M, Goodheart, MJ, Mutch, DG, Kavanagh, JJ, Maxwell, GL & Bookman, MA 2018, 'Clinicopathologic characteristics associated with long-term survival in advanced epithelial ovarian cancer: an NRG Oncology/Gynecologic Oncology Group ancillary data study', Gynecologic Oncology, vol. 148, no. 2, pp. 275-280. https://doi.org/10.1016/j.ygyno.2017.11.018
Hamilton, C. A. ; Miller, A. ; Casablanca, Y. ; Horowitz, N. S. ; Rungruang, Bunja Jane ; Krivak, T. C. ; Richard, S. D. ; Rodriguez, N. ; Birrer, M. J. ; Backes, F. J. ; Geller, M. A. ; Quinn, M. ; Goodheart, M. J. ; Mutch, D. G. ; Kavanagh, J. J. ; Maxwell, G. L. ; Bookman, M. A. / Clinicopathologic characteristics associated with long-term survival in advanced epithelial ovarian cancer : an NRG Oncology/Gynecologic Oncology Group ancillary data study. In: Gynecologic Oncology. 2018 ; Vol. 148, No. 2. pp. 275-280.
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abstract = "Objective: To identify clinicopathologic factors associated with 10-year overall survival in epithelial ovarian cancer (EOC) and primary peritoneal cancer (PPC), and to develop a predictive model identifying long-term survivors. Methods: Demographic, surgical, and clinicopathologic data were abstracted from GOG 182 records. The association between clinical variables and long-term survival (LTS) (> 10 years) was assessed using multivariable regression analysis. Bootstrap methods were used to develop predictive models from known prognostic clinical factors and predictive accuracy was quantified using optimism-adjusted area under the receiver operating characteristic curve (AUC). Results: The analysis dataset included 3010 evaluable patients, of whom 195 survived greater than ten years. These patients were more likely to have better performance status, endometrioid histology, stage III (rather than stage IV) disease, absence of ascites, less extensive preoperative disease distribution, microscopic disease residual following cyoreduction (R0), and decreased complexity of surgery (p < 0.01). Multivariable regression analysis revealed that lower CA-125 levels, absence of ascites, stage, and R0 were significant independent predictors of LTS. A predictive model created using these variables had an AUC = 0.729, which outperformed any of the individual predictors. Conclusions: The absence of ascites, a low CA-125, stage, and R0 at the time of cytoreduction are factors associated with LTS when controlling for other confounders. An extensively annotated clinicopathologic prediction model for LTS fell short of clinical utility suggesting that prognostic molecular profiles are needed to better predict which patients are likely to be long-term survivors.",
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T1 - Clinicopathologic characteristics associated with long-term survival in advanced epithelial ovarian cancer

T2 - an NRG Oncology/Gynecologic Oncology Group ancillary data study

AU - Hamilton, C. A.

AU - Miller, A.

AU - Casablanca, Y.

AU - Horowitz, N. S.

AU - Rungruang, Bunja Jane

AU - Krivak, T. C.

AU - Richard, S. D.

AU - Rodriguez, N.

AU - Birrer, M. J.

AU - Backes, F. J.

AU - Geller, M. A.

AU - Quinn, M.

AU - Goodheart, M. J.

AU - Mutch, D. G.

AU - Kavanagh, J. J.

AU - Maxwell, G. L.

AU - Bookman, M. A.

PY - 2018/2

Y1 - 2018/2

N2 - Objective: To identify clinicopathologic factors associated with 10-year overall survival in epithelial ovarian cancer (EOC) and primary peritoneal cancer (PPC), and to develop a predictive model identifying long-term survivors. Methods: Demographic, surgical, and clinicopathologic data were abstracted from GOG 182 records. The association between clinical variables and long-term survival (LTS) (> 10 years) was assessed using multivariable regression analysis. Bootstrap methods were used to develop predictive models from known prognostic clinical factors and predictive accuracy was quantified using optimism-adjusted area under the receiver operating characteristic curve (AUC). Results: The analysis dataset included 3010 evaluable patients, of whom 195 survived greater than ten years. These patients were more likely to have better performance status, endometrioid histology, stage III (rather than stage IV) disease, absence of ascites, less extensive preoperative disease distribution, microscopic disease residual following cyoreduction (R0), and decreased complexity of surgery (p < 0.01). Multivariable regression analysis revealed that lower CA-125 levels, absence of ascites, stage, and R0 were significant independent predictors of LTS. A predictive model created using these variables had an AUC = 0.729, which outperformed any of the individual predictors. Conclusions: The absence of ascites, a low CA-125, stage, and R0 at the time of cytoreduction are factors associated with LTS when controlling for other confounders. An extensively annotated clinicopathologic prediction model for LTS fell short of clinical utility suggesting that prognostic molecular profiles are needed to better predict which patients are likely to be long-term survivors.

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KW - Long-term survival

KW - Ovarian cancer

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