Nomogram for Predicting Individual Survival After Recurrence of Advanced-Stage, High-Grade Ovarian Carcinoma.

Journal Article (Journal Article;Multicenter Study)

OBJECTIVE: To analyze clinical prognostic factors for survival after recurrence of high-grade, advanced-stage ovarian-peritoneal-tubal carcinoma and to develop a nomogram to predict individual survival after recurrence. METHODS: We retrospectively analyzed patients treated in multicenter Gynecologic Oncology Group protocols for stage III and IV ovarian-peritoneal-tubal carcinoma who underwent primary debulking surgery, received chemotherapy with paclitaxel and a platinum compound, and subsequently developed recurrence. Prognostic factors affecting survival were identified and used to develop a nomogram, which was both internally and externally validated. RESULTS: There were 4,739 patients included in this analysis, of whom, 84% had stage III and 16% had stage IV ovarian carcinoma. At a median follow-up of 88.8 months (95% CI 86.2-92.0 months), the vast majority of patients (89.4%) had died. The median survival after recurrence was 21.4 months (95% CI 20.5-21.9 months). Time to recurrence after initial chemotherapy, clear cell or mucinous histology, performance status, stage IV disease, and age were significant variables used to develop a nomogram for survival after recurrence, which had a concordance index of 0.67. The time to recurrence alone accounted for 85% of the prognostic information. Similar results were found for patients who underwent second look laparotomy and had a complete pathologic response or received intraperitoneal chemotherapy. CONCLUSION: For individuals with advanced-stage ovarian carcinoma who recur after standard first-line therapy, estimated survivals after recurrence are closely related to the time to recurrence after chemotherapy and prognostic variables can be used to predict subsequent survival. CLINICAL TRIAL REGISTRATION:, NCT00002568, NCT00837993, NCT00002717, NCT01074398, and NCT00011986.

Full Text

Duke Authors

Cited Authors

  • Rose, PG; Java, JJ; Salani, R; Geller, MA; Secord, AA; Tewari, KS; Bender, DP; Mutch, DG; Friedlander, ML; Van Le, L; Method, MW; Hamilton, CA; Lee, RB; Wenham, RM; Guntupalli, SR; Markman, M; Muggia, FM; Armstrong, DK; Bookman, MA; Burger, RA; Copeland, LJ

Published Date

  • February 2019

Published In

Volume / Issue

  • 133 / 2

Start / End Page

  • 245 - 254

PubMed ID

  • 30633128

Pubmed Central ID

  • PMC6551603

Electronic International Standard Serial Number (EISSN)

  • 1873-233X

Digital Object Identifier (DOI)

  • 10.1097/AOG.0000000000003086


  • eng

Conference Location

  • United States