Retrospective study of patients with tubo-ovarian cancers (n = 510) and an analysis of main factors influencing PFS and OS – the experience of a comprehensive oncology center during 2010–2019
Abstract
Background: C56 malignancies are significant diseases. In the Czech Republic, the incidence of 956 and mortality of 637 cases were reported in 2018 (data from the registry of the Institute of Health Information and Statistics of the Czech Republic).
Carciomas are a dominant group. The backbone of first-line treatment is a sufficiently radical surgery and chemotherapy with carboplatin (paclitaxel/ carboplatin) in the vast majority of cases.
Analyses of treatment outcomes in CZ centers are presented infrequently. Patients and methods: Patients with a new diagnosis and morphologically verified tubo-ovarian cancer in the period 2010-2019 and active care within comprehensive oncology centre FN Plzen.
Basic factors with possible influence on time from diagnosis to progression (progression-free survival - PFS) or death (overall survival - OS) were monitored: the state of complete remission (CR) in the first line of treatment (yes vs. no), grade (low = 1-2 vs. high = 3-4), stage (1 vs. 2 vs. 3 vs. 4), type (serous v. non-serous, unspecified), age (= 65 years), year of diagnosis (2010-2012 vs. 2017-2019). The Kaplan-Meier estimate of survival function, log-rank test and median survival were used for PFS and OS analysis.
Results: Registered n = 510 patients, of which n = 498 valid for PFS and n = 507 for OS. A statistically significant difference in survival curves (P = 65 years (15 months).
Statistically significant differences in OS (P = 65 years (32 months). A statistically significant difference between PFS and OS according to the type of malignancy and the year of diagnosis was not proven.
Conclusion: The presented set can be considered representative and unselected. We confirm the generally expected results, which are the result of a comprehensive multidisciplinary cooperation with the crucial position of surgical resections (note: in unresectable cases, the state of CR during chemotherapy with potentially bevacizumab was only 9%).
Comparison of the results by treatment period (2010-2012 vs. 2017-2019) did not show differences and further monitoring or multicentre cooperation would be needed to evaluate the effect of bevacizumab, or more recently PARPi maintenance treatment, or the concentration of surgery in complex cancer centers. The real world data file can be a source for further analysis and research.