Survival of Australian women with invasive epithelial ovarian cancer: a population-based study

S. Anuradha, P.M. Webb, P.I. Blomfield, A.H. Brand, M.L.E. Friedlander, Yee Leung, A. Obermair, M.K. Oehler, M.A. Quinn, C.B. Steer, S.J. Jordan

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    Abstract

    Objective: To describe survival patterns in a nationally complete cohort of Australian women with epithelial ovarian cancer, by sociodemographic and clinical factors. Design, setting and participants: All 1192 women diagnosed with invasive epithelial ovarian cancer in 2005 were identified through state-based cancer registries. We obtained detailed information from their medical records in 2009 and updated survival data in 2012. Main outcome measures: Crude 3-year, 5-year and 7-year survival rates; 3-year and 5-year conditional survival; and hazard ratios (HRs) for the association of participant and cancer characteristics with survival, from multivariable Cox proportional hazards models. Results: Overall crude 5-year survival was 35% (95% CI, 33%-38%). Conditional survival increased moderately for women who lived beyond a year from diagnosis, although for women alive 2 years after diagnosis, the probability of surviving a further 5 years was still only 53% (95% CI, 49%-57%). Increasing age and disease stage were most strongly associated with poor survival. After adjusting for these, survival was significantly worse for women with carcinosarcomas (HRadj, 2.1 [95% CI, 1.3-3.2]), clear cell (HRadj, 1.7 [95% CI, 1.2-2.3]) and mucinous (HRadj, 2.6 [95% CI, 1.6-4.0]) cancers than for women with serous cancers. Presence of ascites at diagnosis (HRadj, 1.5 [95% CI, 1.3-1.8]), Charlson comorbidity score ≥ 3 (HRadj, 1.5 [95% CI, 1.1-2.1]), relative socioeconomic disadvantage (HRadj, 1.2 [95% CI, 1.1-1.4]) and regional-remote residence (HRadj, 1.2 [95% CI, 1.0-1.4]) were also associated with poorer survival. Conclusions: Along with expected adverse effects of age and stage, we found survival differences by histological subtype, presence of ascites and comorbidities. Whether geographic and socioeconomic differences relate to treatment access or other factors warrants further investigation. Conditional survival estimates confirm the ongoing poor long-term prognosis for women with ovarian cancer, reinforcing the need for prevention and better treatments.
    Original languageEnglish
    Pages (from-to)283-288
    JournalMedical Journal of Australia
    Volume201
    Issue number5
    DOIs
    Publication statusPublished - 1 Sep 2014

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    Survival
    Population
    Ascites
    Comorbidity
    Neoplasms
    Ovarian epithelial cancer
    Carcinosarcoma
    Proportional Hazards Models
    Ovarian Neoplasms
    Medical Records
    Registries
    Survival Rate
    Outcome Assessment (Health Care)
    Therapeutics

    Cite this

    Anuradha, S., Webb, P. M., Blomfield, P. I., Brand, A. H., Friedlander, M. L. E., Leung, Y., ... Jordan, S. J. (2014). Survival of Australian women with invasive epithelial ovarian cancer: a population-based study. Medical Journal of Australia, 201(5), 283-288. https://doi.org/10.5694/mja14.00132
    Anuradha, S. ; Webb, P.M. ; Blomfield, P.I. ; Brand, A.H. ; Friedlander, M.L.E. ; Leung, Yee ; Obermair, A. ; Oehler, M.K. ; Quinn, M.A. ; Steer, C.B. ; Jordan, S.J. / Survival of Australian women with invasive epithelial ovarian cancer: a population-based study. In: Medical Journal of Australia. 2014 ; Vol. 201, No. 5. pp. 283-288.
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    title = "Survival of Australian women with invasive epithelial ovarian cancer: a population-based study",
    abstract = "Objective: To describe survival patterns in a nationally complete cohort of Australian women with epithelial ovarian cancer, by sociodemographic and clinical factors. Design, setting and participants: All 1192 women diagnosed with invasive epithelial ovarian cancer in 2005 were identified through state-based cancer registries. We obtained detailed information from their medical records in 2009 and updated survival data in 2012. Main outcome measures: Crude 3-year, 5-year and 7-year survival rates; 3-year and 5-year conditional survival; and hazard ratios (HRs) for the association of participant and cancer characteristics with survival, from multivariable Cox proportional hazards models. Results: Overall crude 5-year survival was 35{\%} (95{\%} CI, 33{\%}-38{\%}). Conditional survival increased moderately for women who lived beyond a year from diagnosis, although for women alive 2 years after diagnosis, the probability of surviving a further 5 years was still only 53{\%} (95{\%} CI, 49{\%}-57{\%}). Increasing age and disease stage were most strongly associated with poor survival. After adjusting for these, survival was significantly worse for women with carcinosarcomas (HRadj, 2.1 [95{\%} CI, 1.3-3.2]), clear cell (HRadj, 1.7 [95{\%} CI, 1.2-2.3]) and mucinous (HRadj, 2.6 [95{\%} CI, 1.6-4.0]) cancers than for women with serous cancers. Presence of ascites at diagnosis (HRadj, 1.5 [95{\%} CI, 1.3-1.8]), Charlson comorbidity score ≥ 3 (HRadj, 1.5 [95{\%} CI, 1.1-2.1]), relative socioeconomic disadvantage (HRadj, 1.2 [95{\%} CI, 1.1-1.4]) and regional-remote residence (HRadj, 1.2 [95{\%} CI, 1.0-1.4]) were also associated with poorer survival. Conclusions: Along with expected adverse effects of age and stage, we found survival differences by histological subtype, presence of ascites and comorbidities. Whether geographic and socioeconomic differences relate to treatment access or other factors warrants further investigation. Conditional survival estimates confirm the ongoing poor long-term prognosis for women with ovarian cancer, reinforcing the need for prevention and better treatments.",
    author = "S. Anuradha and P.M. Webb and P.I. Blomfield and A.H. Brand and M.L.E. Friedlander and Yee Leung and A. Obermair and M.K. Oehler and M.A. Quinn and C.B. Steer and S.J. Jordan",
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    Anuradha, S, Webb, PM, Blomfield, PI, Brand, AH, Friedlander, MLE, Leung, Y, Obermair, A, Oehler, MK, Quinn, MA, Steer, CB & Jordan, SJ 2014, 'Survival of Australian women with invasive epithelial ovarian cancer: a population-based study' Medical Journal of Australia, vol. 201, no. 5, pp. 283-288. https://doi.org/10.5694/mja14.00132

    Survival of Australian women with invasive epithelial ovarian cancer: a population-based study. / Anuradha, S.; Webb, P.M.; Blomfield, P.I.; Brand, A.H.; Friedlander, M.L.E.; Leung, Yee; Obermair, A.; Oehler, M.K.; Quinn, M.A.; Steer, C.B.; Jordan, S.J.

    In: Medical Journal of Australia, Vol. 201, No. 5, 01.09.2014, p. 283-288.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Survival of Australian women with invasive epithelial ovarian cancer: a population-based study

    AU - Anuradha, S.

    AU - Webb, P.M.

    AU - Blomfield, P.I.

    AU - Brand, A.H.

    AU - Friedlander, M.L.E.

    AU - Leung, Yee

    AU - Obermair, A.

    AU - Oehler, M.K.

    AU - Quinn, M.A.

    AU - Steer, C.B.

    AU - Jordan, S.J.

    PY - 2014/9/1

    Y1 - 2014/9/1

    N2 - Objective: To describe survival patterns in a nationally complete cohort of Australian women with epithelial ovarian cancer, by sociodemographic and clinical factors. Design, setting and participants: All 1192 women diagnosed with invasive epithelial ovarian cancer in 2005 were identified through state-based cancer registries. We obtained detailed information from their medical records in 2009 and updated survival data in 2012. Main outcome measures: Crude 3-year, 5-year and 7-year survival rates; 3-year and 5-year conditional survival; and hazard ratios (HRs) for the association of participant and cancer characteristics with survival, from multivariable Cox proportional hazards models. Results: Overall crude 5-year survival was 35% (95% CI, 33%-38%). Conditional survival increased moderately for women who lived beyond a year from diagnosis, although for women alive 2 years after diagnosis, the probability of surviving a further 5 years was still only 53% (95% CI, 49%-57%). Increasing age and disease stage were most strongly associated with poor survival. After adjusting for these, survival was significantly worse for women with carcinosarcomas (HRadj, 2.1 [95% CI, 1.3-3.2]), clear cell (HRadj, 1.7 [95% CI, 1.2-2.3]) and mucinous (HRadj, 2.6 [95% CI, 1.6-4.0]) cancers than for women with serous cancers. Presence of ascites at diagnosis (HRadj, 1.5 [95% CI, 1.3-1.8]), Charlson comorbidity score ≥ 3 (HRadj, 1.5 [95% CI, 1.1-2.1]), relative socioeconomic disadvantage (HRadj, 1.2 [95% CI, 1.1-1.4]) and regional-remote residence (HRadj, 1.2 [95% CI, 1.0-1.4]) were also associated with poorer survival. Conclusions: Along with expected adverse effects of age and stage, we found survival differences by histological subtype, presence of ascites and comorbidities. Whether geographic and socioeconomic differences relate to treatment access or other factors warrants further investigation. Conditional survival estimates confirm the ongoing poor long-term prognosis for women with ovarian cancer, reinforcing the need for prevention and better treatments.

    AB - Objective: To describe survival patterns in a nationally complete cohort of Australian women with epithelial ovarian cancer, by sociodemographic and clinical factors. Design, setting and participants: All 1192 women diagnosed with invasive epithelial ovarian cancer in 2005 were identified through state-based cancer registries. We obtained detailed information from their medical records in 2009 and updated survival data in 2012. Main outcome measures: Crude 3-year, 5-year and 7-year survival rates; 3-year and 5-year conditional survival; and hazard ratios (HRs) for the association of participant and cancer characteristics with survival, from multivariable Cox proportional hazards models. Results: Overall crude 5-year survival was 35% (95% CI, 33%-38%). Conditional survival increased moderately for women who lived beyond a year from diagnosis, although for women alive 2 years after diagnosis, the probability of surviving a further 5 years was still only 53% (95% CI, 49%-57%). Increasing age and disease stage were most strongly associated with poor survival. After adjusting for these, survival was significantly worse for women with carcinosarcomas (HRadj, 2.1 [95% CI, 1.3-3.2]), clear cell (HRadj, 1.7 [95% CI, 1.2-2.3]) and mucinous (HRadj, 2.6 [95% CI, 1.6-4.0]) cancers than for women with serous cancers. Presence of ascites at diagnosis (HRadj, 1.5 [95% CI, 1.3-1.8]), Charlson comorbidity score ≥ 3 (HRadj, 1.5 [95% CI, 1.1-2.1]), relative socioeconomic disadvantage (HRadj, 1.2 [95% CI, 1.1-1.4]) and regional-remote residence (HRadj, 1.2 [95% CI, 1.0-1.4]) were also associated with poorer survival. Conclusions: Along with expected adverse effects of age and stage, we found survival differences by histological subtype, presence of ascites and comorbidities. Whether geographic and socioeconomic differences relate to treatment access or other factors warrants further investigation. Conditional survival estimates confirm the ongoing poor long-term prognosis for women with ovarian cancer, reinforcing the need for prevention and better treatments.

    U2 - 10.5694/mja14.00132

    DO - 10.5694/mja14.00132

    M3 - Article

    VL - 201

    SP - 283

    EP - 288

    JO - Medical Journal Australia

    JF - Medical Journal Australia

    SN - 0025-729X

    IS - 5

    ER -