Surgical and survival outcomes of advanced epithelial ovarian cancer

Background: Ovarian cancer is the 8th commonest cancer affecting females. It is usually discovered late due to lack of specific symptoms & effective screening. Prognosis is poor with advanced stages (III/IV) estimated 5-years overall survival of 15-25%. Age, stage, residual disease & histological type are the main factors affecting survival. Aim: To identify the surgical and survival outcomes in advanced epithelial ovarian cancer in our patient population. Materials & methods: Single institution prospective analysis of all cases of advanced epithelial ovarian cancer treated at our institute from September 2018 till September 2020. 56 cases were included. Results: 19 (33.9%) underwent primary debulking surgery whereas 37 (66.1%) had interval debulking surgery. Median age was 55.5 years (range 20-86 years). Median preoperative CA-125 level was 570 U/ml (range 145-28000 U/ml). Commonest histological subtype was serous. Complete cytoreductive surgery was fulfilled in 37 cases (66.1%). Median follow-up was 22 months (range 1-34 months). Overall survival at 1 & 2 years was 90.8% & 80% respectively while progression free survival at 1 & 2 years was 89% & 69.7% respectively. Overall survival significant factors on univariate level were CA-125 level, liver metastasis & late complications. On multivariate analysis for overall survival; only CA125 & late complications showed independent prognostic effects. For progression free survival, peritoneal invasion & late complications were significant variables on univariate level. By multivariate analysis for progression free survival, late complications only showed independent prognostic effects. Conclusion: CA125 level and late complications are prognostic factors for survival in advanced stage epithelial ovarian cancers.