Ovarian cancer natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Ovarian cancer is often diagnosed late resulting in a poor overall outcome for the patient.

Complications

  • Spread of the cancer to other organs
  • Progressive function loss of various organs
  • Ascites (fluid in the abdomen)
  • Intestinal obstruction

Prognosis

Ovarian cancer has a poor prognosis. It is disproportionately deadly because symptoms are vague and non-specific, hence diagnosis is late. More than 60% of patients presenting with this cancer already have stage III or stage IV cancer, when it has already spread beyond the ovaries.

Ovarian cancers that are malignant shed cells into the naturally occurring fluid within the abdominal cavity. These cells can implant on other abdominal (peritoneal) structures included the uterus, urinary bladder, bowel, lining of the bowel wall (omentum) and can even spread to the lungs. These cells can begin forming new tumor growths before cancer is even suspected.

More than 50% of women with ovarian cancer are diagnosed in the advanced stages of the disease because no cost-effective screening test for ovarian cancer exists. The five year survival rate for all stages is only 35% to 38%. If, however, diagnosis is made early in the disease, five-year survival rates can reach 90% to 98%.

Germ cell tumors of the ovary have a much better prognosis than other ovarian cancers, in part because they tend to grow rapidly to a very large size, hence they are detected sooner.

5-Year Survival

  • Between 2004 and 2010, the 5-year relative survival of patients with ovarian cancer was 44.6%.[1]
  • When stratified by age, the 5-year relative survival of patients with ovarian cancer was 57.5% and 27.3% for patients <65 and ≥ 65 years of age respectively.[1]
  • The survival of patients with ovarian cancer varies with the stage of the disease. Shown below is a table depicting the 5-year relative survival by the stage of ovarian cancer:[1]
Stage 5-year relative survival (%), (2004-2010)
All stages 44.5%
Localized 92.3%
Regional 71.7%
Distant 27.4%
Unstaged 21.7%
  • Shown below is an image depicting the 5-year conditional relative survival (probability of surviving in the next 5-years given the cohort has already survived 0, 1, 3 years) between 1998 and 2010 of ovarian cancer by stage at diagnosis according to SEER. These graphs are adapted from SEER: The Surveillance, Epidemiology, and End Results Program of the National Cancer Institute.[1]

5-year conditional relative survival (probability of surviving in the next 5-years given the cohort has already survived 0, 1, 3 years) between 1998 and 2010 of ovarian cancer by stage at diagnosis according to SEER

References

  1. 1.0 1.1 1.2 1.3 Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.



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