Treatments and Outcomes of Epithelial Ovarian Cancers in Srinagarind Hospital
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Abstract
Objectives: To compare treatments of epithelial ovarian cancers (including fallopian tube cancer and primary peritoneal adenocarcinoma) with national guidelines and oncological outcomes between standard and non-standard treatment groups.
Materials and Methods: Retrospective chart reviews were performed on patients with epithelial ovarian cancers, fallopian tube cancer and primary peritoneal adenocarcinoma (n = 318) who had been registered in Department Obstetrics and Gynecology, Srinagarind Hospital, between January 1st, 2014 and December 31st, 2019. Surgical treatments and adjuvant treatments were compared with national guidelines. Oncological outcomes were compared between standard and non-standard treatment groups. Univariate and multivariate logistic regression analyses were used for factors to receive which treatment. Survival rates were analyzed by Kaplan-Meier and prognostic factors were compared among the two groups by Cox-regression for factors to receive longer overall survival.
Results: A total of 318 patients were recruited. Most patients were diagnosed with epithelial ovarian cancers (89.9%). The major pathology was high grade carcinoma (53.8%). Surgeries were done in most patients (92.1%), which were primary cytoreductive surgery (72.4%) and complete surgical staging (80.5%). Residual tumors of more than 5 mm in diameter were left in 42.3%. Standard and non-standard treatment of epithelial ovarian cancers were found in 60.4% (95% confidence interval: 54.9-65.6%) and 39.6%, respectively. Chemotherapies were given to most patients (86.8%). Five-year survival rates and recurrence free survival rates were 42.2% and 26.8%. Overall survival rate was significantly lower in the non-standard group (adjusted hazard ratio = 1.42, 95% confidence interval: 1.01-2.02, p = 0.046).
Conclusion: National guidelines on treatment of epithelial ovarian cancers should be followed, because of poorer outcomes in the non-standard groups.
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