Stage IV ovarian cancer

Disease site-specific rationale for postoperative treatment

Giovanni D. Aletti, Karl C. Podratz, William A. Cliby, Bobbie S. Gostout

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Objectives: We aimed to define the site-specific patterns of treatment failure in stage IV ovarian cancer. Methods: Data from all consecutive Mayo Clinic patients with stage IV epithelial ovarian cancer, from 1994 through 2003, were collected and analyzed. Statistical analyses included the χ2 test and Kaplan-Meier curves with log-rank tests. Results: Review of our patient database identified 109 patients with stage IV ovarian cancer: mean age, 62 years (range, 36-83 years); 5-year overall survival, 15%. Most patients (74%) had intraperitoneal disease at the time of relapse, 36% had pleural effusion, and 49% had extraperitoneal metastases. At the time of death 75% had intraperitoneal localizations, 51% had pleural effusion, and 46% had extraperitoneal metastases. Patients with pleural effusion were more likely to have pleural disease at relapse and at last follow-up. Extrapleural disease at the time of diagnosis predicted extrapleural disease at relapse and at last follow-up. Most patients classified as having stage IV disease by pleural cytology only, as opposed to all other patients, had intraperitoneal disease at relapse (88% vs 58.7%, P = .001) and last follow-up (88.5% vs 59.6%, P = .001). Patients having stage IV disease by pleural cytology only had survival benefit when disease was optimally debulked in the abdomen and pelvis (median survival, 3.1 years vs 1.3 years; P = .001). Patients with multiple unresectable liver metastases had poor prognosis (median survival, 1.2 years) owing to progression of liver disease. Conclusions: Clinical trials for stage IV ovarian cancer should reflect the site-specific risks for recurrence according to disease location at diagnosis.

Original languageEnglish
Pages (from-to)22-27
Number of pages6
JournalGynecologic Oncology
Volume112
Issue number1
DOIs
Publication statusPublished - Jan 2009

Fingerprint

Ovarian Diseases
Ovarian Neoplasms
Pleural Diseases
Recurrence
Pleural Effusion
Therapeutics
Survival
Neoplasm Metastasis
Cell Biology
Kaplan-Meier Estimate
Treatment Failure
Pelvis
Abdomen
Liver Diseases
Clinical Trials
Databases

Keywords

  • Liver metastases
  • Pleural effusion
  • Recurrent disease
  • Stage IV ovarian cancer
  • Surgery

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology

Cite this

Stage IV ovarian cancer : Disease site-specific rationale for postoperative treatment. / Aletti, Giovanni D.; Podratz, Karl C.; Cliby, William A.; Gostout, Bobbie S.

In: Gynecologic Oncology, Vol. 112, No. 1, 01.2009, p. 22-27.

Research output: Contribution to journalArticle

Aletti, Giovanni D. ; Podratz, Karl C. ; Cliby, William A. ; Gostout, Bobbie S. / Stage IV ovarian cancer : Disease site-specific rationale for postoperative treatment. In: Gynecologic Oncology. 2009 ; Vol. 112, No. 1. pp. 22-27.
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