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Cancer of the ovary, fallopian tube, and peritoneum: a population-based comparison of the prognostic factors and outcomes

  • Original Article – Clinical Oncology
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Abstract

Purpose

The objective was to compare the prognostic factors and outcomes among primary ovarian cancer (OC), fallopian tube cancer (FC), and peritoneal cancer (PC) patients in a population-based setting.

Methods

We analysed 5399 OC, 327 FC, and 416 PC patients diagnosed between 1998 and 2014 in the catchment area of the Munich Cancer Registry (meanwhile 4.8 million inhabitants). Tumour site differences were examined by comparing prognostic factors, treatments, the time to progression, and survival. The effect of the tumour site was additionally analysed by a Cox regression model.

Results

The median age at diagnosis, histology, and FIGO stage significantly differed among the tumour sites (p < 0.001); PC patients were older, more often diagnosed with a serous subtype, and in FIGO stage III or IV. The time to progression and survival significantly differed among the tumour sites. When stratified by FIGO stage, the differences in time to progression disappeared, and the differences in survival considerably weakened. The differences in the multivariate survival analysis showed an almost identical outcome in PC patients (HR 1.07 [0.91–1.25]) and an improved survival of FC patients (HR 0.63 [0.49–0.81]) compared to that of OC patients.

Conclusion

The comparison of OC, FC, and PC patients in this large-scale population-based study showed differences in the prognostic factors. These differences primarily account for the inferior outcome of PC patients, and for the improved survival of FC compared to OC patients.

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References

  • Ataseven B, Chiva LM, Harter P, Gonzalez-Martin A, du Bois A (2016) FIGO stage IV epithelial ovarian, fallopian tube and peritoneal cancer revisited. Gynecol Oncol. doi:10.1016/j.ygyno.2016.06.013

    Google Scholar 

  • Bamias A et al (2012) Prognostic evaluation of tumour type and other histopathological characteristics in advanced epithelial ovarian cancer, treated with surgery and paclitaxel/carboplatin chemotherapy: cell type is the most useful prognostic factor. Eur J Cancer (Oxford, England: 1990) 48:1476–1483. doi:10.1016/j.ejca.2011.09.023

    Article  CAS  Google Scholar 

  • Berek JS, Crum C, Friedlander M (2015) Cancer of the ovary, fallopian tube, and peritoneum. Int J Gynaecol Obstet 131(Suppl 2):S111–S122. doi:10.1016/j.ijgo.2015.06.007

    Article  PubMed  Google Scholar 

  • Braicu EI, Sehouli J, Richter R, Pietzner K, Denkert C, Fotopoulou C (2011) Role of histological type on surgical outcome and survival following radical primary tumour debulking of epithelial ovarian, fallopian tube and peritoneal cancers. Br J Cancer 105:1818–1824. doi:10.1038/bjc.2011.455

    Article  PubMed  PubMed Central  Google Scholar 

  • Bristow RE, Tomacruz RS, Armstrong DK, Trimble EL, Montz FJ (2002) Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a meta-analysis. J Clin Oncol 20:1248–1259

    Article  PubMed  Google Scholar 

  • Chang SJ, Hodeib M, Chang J, Bristow RE (2013) Survival impact of complete cytoreduction to no gross residual disease for advanced-stage ovarian cancer: a meta-analysis. Gynecol Oncol 130:493–498. doi:10.1016/j.ygyno.2013.05.040

    Article  PubMed  Google Scholar 

  • Chene G, Dauplat J, Radosevic-Robin N, Cayre A, Penault-Llorca F (2013) Tu-be or not tu-be: that is the question… about serous ovarian carcinogenesis. Crit Rev Oncol Hematol 88:134–143. doi:10.1016/j.critrevonc.2013.03.004

    Article  CAS  PubMed  Google Scholar 

  • du Bois A, Reuss A, Pujade-Lauraine E, Harter P, Ray-Coquard I, Pfisterer J (2009) Role of surgical outcome as prognostic factor in advanced epithelial ovarian cancer: a combined exploratory analysis of 3 prospectively randomized phase 3 multicenter trials: by the Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom (AGO-OVAR) and the Groupe d’Investigateurs Nationaux Pour les Etudes des Cancers de l’Ovaire (GINECO). Cancer 115:1234–1244. doi:10.1002/cncr.24149

    Article  PubMed  Google Scholar 

  • Ederer F, Heise H (1959) Instructions to IBM 650 programmers in processing survival computations. Methodological Note No. 10. End Results Evaluation Section. National Cancer Institute

  • Ferlay J et al (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136:E359–E386. doi:10.1002/ijc.29210

    Article  CAS  PubMed  Google Scholar 

  • Gao B et al (2016) Serous ovarian and primary peritoneal cancers: a comparative analysis of clinico-pathological features, molecular subtypes and treatment outcome. Gynecol Oncol 142:458–464. doi:10.1016/j.ygyno.2016.06.023

    Article  CAS  PubMed  Google Scholar 

  • Gershenson DM et al (2015) Impact of age and primary disease site on outcome in women with low-grade serous carcinoma of the ovary or peritoneum: results of a large single-institution registry of a rare tumor. J Clin Oncol 33:2675–2682. doi:10.1200/jco.2015.61.0873

    Article  PubMed  PubMed Central  Google Scholar 

  • Gibson SJ, Fleming GF, Temkin SM, Chase DM (2016) The application and outcome of standard of care treatment in elderly women with ovarian cancer: a literature review over the last 10 years. Front Oncol 6:63. doi:10.3389/fonc.2016.00063

    Article  PubMed  PubMed Central  Google Scholar 

  • Grabowski JP et al (2016) Operability and chemotherapy responsiveness in advanced low-grade serous ovarian cancer. An analysis of the AGO Study Group metadatabase. Gynecol Oncol 140:457–462. doi:10.1016/j.ygyno.2016.01.022

    Article  PubMed  Google Scholar 

  • Kalbfleisch J, Prentice R (1980) The statistical analysis of failure time data. Wiley, New York

    Google Scholar 

  • Kaldawy A, Segev Y, Lavie O, Auslender R, Sopik V, Narod SA (2016) Low-grade serous ovarian cancer: a review. Gynecol Oncol. doi:10.1016/j.ygyno.2016.08.320

    PubMed  Google Scholar 

  • Kleppe M, van der Aa MA, Van Gorp T, Slangen BF, Kruitwagen RF (2016) The impact of lymph node dissection and adjuvant chemotherapy on survival: a nationwide cohort study of patients with clinical early-stage ovarian cancer. Eur J Cancer (Oxford, England: 1990) 66:83–90. doi:10.1016/j.ejca.2016.07.015

    Article  Google Scholar 

  • Kurman RJ, Carcangiu ML, Herrington CS, Young RH (2014) WHO classification of tumour of female reproductive organs, 4th edn. International Agency for Research on Cancer, Lyon

    Google Scholar 

  • Munich Cancer Registry (2016) Catchment area of MCR. http://www.tumorregister-muenchen.de/en/area.php. Accessed 4 Oct 2016

  • Rauh-Hain JA et al (2015) Clinical characteristics and outcomes of patients with stage I epithelial ovarian cancer compared with fallopian tube cancer. Am J Obstet Gynecol 212:600.e601–608. doi:10.1016/j.ajog.2014.12.013

  • Robert Koch Institute (RKI) (2014) Cancer in Germany 2009/2010, 9th edn. German Centre for Cancer Registry Data (ZfKD). http://www.krebsdaten.de/Krebs/EN. Accessed 5 Oct 2016

  • Sant M et al (2015) Survival of women with cancers of breast and genital organs in Europe 1999–2007: results of the EUROCARE-5 study. Eur J Cancer (Oxford, England: 1990). doi:10.1016/j.ejca.2015.07.022

    Google Scholar 

  • Schnack TH, Sorensen RD, Nedergaard L, Hogdall C (2014) Demographic clinical and prognostic characteristics of primary ovarian, peritoneal and tubal adenocarcinomas of serous histology—a prospective comparative study. Gynecol Oncol 135:278–284. doi:10.1016/j.ygyno.2014.08.020

    Article  PubMed  Google Scholar 

  • Seidman JD, Zhao P, Yemelyanova A (2011) “Primary peritoneal” high-grade serous carcinoma is very likely metastatic from serous tubal intraepithelial carcinoma: assessing the new paradigm of ovarian and pelvic serous carcinogenesis and its implications for screening for ovarian cancer. Gynecol Oncol 120:470–473. doi:10.1016/j.ygyno.2010.11.020

    Article  PubMed  Google Scholar 

  • Sobin L, Gospodarowicz M, Wittekind C (2009) TNM classification of malignant tumours. International union against cancer (UICC), 7th edn. Wiley-Liss, New York

    Google Scholar 

  • Sorensen RD, Schnack TH, Karlsen MA, Hogdall CK (2015) Serous ovarian, fallopian tube and primary peritoneal cancers: a common disease or separate entities—a systematic review. Gynecol Oncol 136:571–581. doi:10.1016/j.ygyno.2015.01.534

    Article  PubMed  Google Scholar 

  • Usach I, Blansit K, Chen LM, Ueda S, Brooks R, Kapp DS, Chan JK (2015) Survival differences in women with serous tubal, ovarian, peritoneal, and uterine carcinomas. Am J Obstet Gynecol 212:188.e181–186. doi:10.1016/j.ajog.2014.08.016

  • Wethington SL et al (2008) Improved survival for fallopian tube cancer: a comparison of clinical characteristics and outcome for primary fallopian tube and ovarian cancer. Cancer 113:3298–3306. doi:10.1002/cncr.23957

    Article  PubMed  Google Scholar 

  • Winter WE 3rd et al (2007) Prognostic factors for stage III epithelial ovarian cancer: a Gynecologic Oncology Group Study. J Clin Oncol 25:3621–3627. doi:10.1200/jco.2006.10.2517

    Article  PubMed  Google Scholar 

  • Woopen H, Inci G, Richter R, Chekerov R, Ismaeel F, Sehouli J (2016) Elderly ovarian cancer patients: an individual participant data meta-analysis of the North-Eastern German Society of Gynecological Oncology (NOGGO). Eur J Cancer (Oxford, England: 1990) 60:101–106. doi:10.1016/j.ejca.2016.03.008

    Article  CAS  Google Scholar 

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Acknowledgements

We thank all the hospitals, departments, and practitioners who participated in the documentation of the data. The Munich Cancer Registry (MCR) is part of the Munich Tumour Centre (TZM), the Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), the Ludwig-Maximilians-Universität (LMU), and the University Hospital of Munich (KUM).

Author information

Authors and Affiliations

  1. Munich Cancer Registry (MCR) of the Munich Tumour Centre (TZM), Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), University Hospital of Munich, Ludwig-Maximilians-Universität (LMU), Munich, Germany

    Miriam Rottmann, G. Schubert-Fritschle & J. Engel

  2. Department of Gynaecology and Obstetrics, University Hospital of Munich, Ludwig-Maximilians-Universität (LMU), Munich, Germany

    A. Burges & S. Mahner

  3. Department of Gynaecology and Obstetrics, Klinikum Starnberg, Starnberg, Germany

    C. Anthuber

  4. Department of Gynaecology, RoMed Hospital Rosenheim, Rosenheim, Germany

    T. Beck

  5. Department of Gynaecology and Obstetrics, Klinikum Harlaching, Munich, Germany

    D. Grab

  6. Department of Gynaecology and Obstetrics, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany

    A. Schnelzer & M. Kiechle

  7. Department of Pathology, University Hospital of Munich, Ludwig-Maximilians-Universität (LMU), Munich, Germany

    D. Mayr

  8. Department of Gynaecology, Red Cross Hospital, Munich, Germany

    M. Pölcher

Authors
  1. Miriam Rottmann
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  2. A. Burges
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  3. S. Mahner
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  4. C. Anthuber
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  5. T. Beck
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  6. D. Grab
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  7. A. Schnelzer
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  8. M. Kiechle
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  9. D. Mayr
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  10. M. Pölcher
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  11. G. Schubert-Fritschle
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  12. J. Engel
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Corresponding author

Correspondence to Miriam Rottmann.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Human rights All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required. Welfare of animals This article does not contain any studies with animals performed by one of the authors.

Appendix

Appendix

Table 4 Cox regression model (overall survival) for patients with serous carcinoma who underwent surgery (FIGO III + IV)
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Table 5 Cox regression model (overall survival) for patients with high-grade (G2, G3) serous carcinoma who underwent surgery (FIGO III + IV)
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Fig. 6
figure 6

Progression free survival based on tumour site in patients with serous carcinoma (M0)

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Fig. 7
figure 7

Progression free survival based on tumour site and FIGO stage in patients with serous carcinoma (M0)

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Rottmann, M., Burges, A., Mahner, S. et al. Cancer of the ovary, fallopian tube, and peritoneum: a population-based comparison of the prognostic factors and outcomes. J Cancer Res Clin Oncol 143, 1833–1844 (2017). https://doi.org/10.1007/s00432-017-2422-6

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  • DOI: https://doi.org/10.1007/s00432-017-2422-6

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