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Invasive Epithelial Ovarian Cancer Survival by Histotype and Disease Stage.

Publication ,  Journal Article
Peres, LC; Cushing-Haugen, KL; Köbel, M; Harris, HR; Berchuck, A; Rossing, MA; Schildkraut, JM; Doherty, JA
Published in: J Natl Cancer Inst
January 1, 2019

BACKGROUND: The understanding of ovarian cancer pathogenesis has recently shifted to recognize distinct changes in how ovarian cancer histotypes are defined. Using the 2014 World Health Organization (WHO) diagnostic guidelines, we classified ovarian cancer histotypes in Surveillance, Epidemiology, and End Results (SEER) cancer registry data and examined survival patterns by histotype and disease stage. METHODS: We extracted data on 28 118 incident epithelial ovarian cancer cases diagnosed in 2004-2014 from SEER and defined histotype using the 2014 WHO guidelines (high-grade serous, low-grade serous, endometrioid, clear cell, mucinous, carcinosarcoma, and malignant Brenner tumors). By histotype and disease stage, we estimated Kaplan-Meier survival curves and calculated age-adjusted overall and cause-specific survival estimates. Cox proportional hazards regression models were used to estimate histotype-specific hazard ratios (HRs) and 95% confidence intervals (CIs) by disease stage while adjusting for age at diagnosis, region, race/ethnicity, and receipt of surgery. RESULTS: Within two years after diagnosis, localized/regional-stage carcinosarcoma and distant-stage mucinous, clear cell, and carcinosarcoma had a higher risk of mortality compared with high-grade serous, with the most pronounced association for localized/regional carcinosarcoma (>1-2-year time period: HR = 3.81, 95% CI = 2.74 to 5.30) and distant-stage mucinous (0-1-year time period: HR = 3.87, 95% CI = 3.45 to 4.34). In the time period more than four to 10 years after diagnosis, hazard ratios for all histotypes relative to high-grade serous, irrespective of disease stage, were less than 1.00. Cumulatively, both localized/regional and distant-stage low-grade serous and endometrioid carcinomas had the most favorable outcomes. CONCLUSIONS: Our large study, which is representative of the United States population and incorporates the most current knowledge of ovarian cancer pathogenesis, highlights the need to recognize ovarian cancer as a set of distinct diseases and not a single entity. Only then will we be able to effectively target the unique features of each histotype to reduce ovarian cancer mortality.

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Published In

J Natl Cancer Inst

DOI

EISSN

1460-2105

Publication Date

January 1, 2019

Volume

111

Issue

1

Start / End Page

60 / 68

Location

United States

Related Subject Headings

  • Young Adult
  • Survival Rate
  • SEER Program
  • Ovarian Neoplasms
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoplasm Invasiveness
  • Middle Aged
  • Humans
  • Follow-Up Studies
 

Citation

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Peres, L. C., Cushing-Haugen, K. L., Köbel, M., Harris, H. R., Berchuck, A., Rossing, M. A., … Doherty, J. A. (2019). Invasive Epithelial Ovarian Cancer Survival by Histotype and Disease Stage. J Natl Cancer Inst, 111(1), 60–68. https://doi.org/10.1093/jnci/djy071
Peres, Lauren C., Kara L. Cushing-Haugen, Martin Köbel, Holly R. Harris, Andrew Berchuck, Mary Anne Rossing, Joellen M. Schildkraut, and Jennifer A. Doherty. “Invasive Epithelial Ovarian Cancer Survival by Histotype and Disease Stage.J Natl Cancer Inst 111, no. 1 (January 1, 2019): 60–68. https://doi.org/10.1093/jnci/djy071.
Peres LC, Cushing-Haugen KL, Köbel M, Harris HR, Berchuck A, Rossing MA, et al. Invasive Epithelial Ovarian Cancer Survival by Histotype and Disease Stage. J Natl Cancer Inst. 2019 Jan 1;111(1):60–8.
Peres, Lauren C., et al. “Invasive Epithelial Ovarian Cancer Survival by Histotype and Disease Stage.J Natl Cancer Inst, vol. 111, no. 1, Jan. 2019, pp. 60–68. Pubmed, doi:10.1093/jnci/djy071.
Peres LC, Cushing-Haugen KL, Köbel M, Harris HR, Berchuck A, Rossing MA, Schildkraut JM, Doherty JA. Invasive Epithelial Ovarian Cancer Survival by Histotype and Disease Stage. J Natl Cancer Inst. 2019 Jan 1;111(1):60–68.
Journal cover image

Published In

J Natl Cancer Inst

DOI

EISSN

1460-2105

Publication Date

January 1, 2019

Volume

111

Issue

1

Start / End Page

60 / 68

Location

United States

Related Subject Headings

  • Young Adult
  • Survival Rate
  • SEER Program
  • Ovarian Neoplasms
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoplasm Invasiveness
  • Middle Aged
  • Humans
  • Follow-Up Studies