SURVIVAL RATES FOR STAGE 3 OVARIAN CANCER. PROGNOSTIC FACTORS
Introduction. At the present stage, the therapy of patients with stage 3 ovarian cancer remains insufficiently effective. Modern methods of treatment of patients are accompanied by low survival, which requires the study of additional prognostic factors to individualize treatment.
Methods. The study is based on the results of treatment of 136 patients with stage 3 ovarian cancer. The three- and five-year overall and recurrence-free survival of ovarian cancer patients, in correlation with treatment and prognosis, namely, histological type of tumor, degree of tumor differentiation, and tumor resuscitation after surgery, was studied and evaluated.
Results. In the structure of ovarian cancer stage 3 for 2014-2019 in Ivano-Frankivsk region a three-year overall survival is 34%, recurrence-free survival is 17%. It was found that no patient with R1-R2 lived without recurrence for 4 years. Patients without residual tumor have a four-year recurrence-free survival (29.4%). Adenocarcinoma G1 was observed in 73 patients, G2 was detected in 29 patients, G3 – respectively in 33 patients. Thus, most patients suffered from highly differentiated tumors (54.1%), 21.5% of patients had moderately differentiated carcinoma.
Conclusions. The work was carried out according to the plan of scientific research of the Ivano-Frankivsk National Medical University (IFNMU) and is a part of the planned scientific theme of the Department of Oncology: state registration number: 0121U109033; 2021-2026 "Individualization of the treatment of cancer of the reproductive system and gastrointestinal tract by studying prognostic factors and improving diagnostic methods." The author is a direct executor of a fragment of research work. It was found that starting from the 4th year of follow-up, the overall survival was higher by 14.1% in patients who received surgery followed by adjuvant chemotherapy compared with patients who received additional neoadjuvant PCT treatment cycles (p˂0.05). Starting from the 24th month, a significantly higher recurrence-free survival was among the patients who did not receive additional neoadjuvant chemotherapy; in the 3rd year of follow-up the recurrence-free survival was 17.9% among patients who underwent surgery with subsequent adjuvant chemotherapy, which is 10.5% more than among patients who received additional neoadjuvant courses of chemotherapy. Clinical and morphological factors related to the survival of patients with stage 3 ovarian cancer have been identified. Negative prognostic factors include R2: 64.4% of patients with R0 have a three-year overall survival, which is 41% higher than in R2, respectively (p˂0.05). In case of R0, the three-year recurrence-free survival is 52.3%, while for R1 and R2 it is 23.2% and 4.4%, respectively, without disease progression (p˂0.05). The prognostic value of G for overall and recurrence-free survival in patients with ovarian cancer was assessed. Favorable prognostic factors include G1: five-year overall survival in case of G1 is 19.7%, which is 11.8% higher than in patients with G3. There were no patients with G2 (p˂0.05). The four-year recurrence-free survival of G1 is 11.2%, which is 3.5% higher than in case of G3. There were no patients with G2 (p˂0.05).
The relapse-free survival of patients with low-differentiated tumors is significantly higher up to the 24th month of observation compared to highly differentiated tumors, from the 36th month of observation, no difference in the survival of patients of the research groups was found.
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