Long term survival outcomes of stage I mucinous ovarian cancer - A clinical calculator predictive of chemotherapy benefit

Michael T. Richardson, David P. Mysona, David A. Klein, Amandeep Mann, Cheng I. Liao, Elisabeth J. Diver, Kathleen M. Darcy, Chunqiao Tian, Jin Xiong She, Sharad Ghamande, Linda Van Le, Daniel S. Kapp, John K. Chan

Research output: Contribution to journalArticle

Abstract

Objectives: To determine the long-term potential benefit of adjuvant chemotherapy in subgroups of high-risk stage I mucinous ovarian cancer patients using a predictive scoring algorithm. Methods: Data were collected from the National Cancer Database from 2004 to 2014. Based on demographic and surgical characteristics, a novel 10-year survival prognostic scoring system was developed using Cox regression. Results: There were 2041 eligible patients with stage I mucinous ovarian cancer including 1362 (67%) with stage IA/IB disease, 598 (29%) with stage IC disease, and 81 (4%) with stage I disease not otherwise specified. Median age was 52 with a range of 13–90 years old. 737 (36%) patients were treated with adjuvant chemotherapy. Adjuvant chemotherapy was more common in patients with stage IC relative to stage IA/IB disease (69% vs. 21%, P < 0.001) or with poorly-differentiated relative to well-differentiated tumors (69% vs. 23%, P < 0.001). Unadjusted 10-year survival was 81% relative to 79% for patients treated with vs. without chemotherapy, respectively (P = 0.46). Patients were predicted to exhibit a low- or a high-risk of death using a multivariate Cox regression model with age, stage, grade, lymphovascular space invasion and ascites. Risk of death without vs. with adjuvant chemotherapy was similar in low-risk patients (88% vs. 84%; HR = 0.80, 95%CI = 0.56–1.15, P = 0.23) and worse in high-risk patients (51% vs. 74%; HR = 1.58, 95%CI: 1.05–2.38, P = 0.03) with stage I mucinous ovarian cancer. Conclusions: A predictive scoring algorithm may provide prognostic information on long-term survival and identify high-risk stage I mucinous ovarian cancer patients who might achieve a survival benefit from adjuvant chemotherapy.

Original languageEnglish (US)
Pages (from-to)118-128
Number of pages11
JournalGynecologic Oncology
Volume159
Issue number1
DOIs
StatePublished - Oct 2020

Keywords

  • Chemotherapy
  • Clinical calculator
  • Mucinous ovarian cancer

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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    Richardson, M. T., Mysona, D. P., Klein, D. A., Mann, A., Liao, C. I., Diver, E. J., Darcy, K. M., Tian, C., She, J. X., Ghamande, S., Van Le, L., Kapp, D. S., & Chan, J. K. (2020). Long term survival outcomes of stage I mucinous ovarian cancer - A clinical calculator predictive of chemotherapy benefit. Gynecologic Oncology, 159(1), 118-128. https://doi.org/10.1016/j.ygyno.2020.07.011