Advanced stage ovarian cancer survival in Jakarta

Abstract

Objective: Ovarian cancer is one of most common cancers among women and has high mortality rate. In Indonesia, most patients initially present with advanced stage disease. Several factors contribute to ovarian cancer survival rate. Here, we evaluate factors that contributed to ovarian cancer survival rate in our medical center. Materials and Methods: This is a retrospective study reporting on 128 advanced stage ovarian cancer cases in Dr. Cipto Mangunkusumo Central General Hospital, a national reference and teaching hospital in Jakarta, Indonesia. Patients were treated with cytoreductive surgery and chemotherapy, and followed for a five-year period. Univariate and multivariate survival analyses were performed to investigate the impact of age, parity, residual tumor, chemotherapy regimen, and lymph nodal status on overall survival. Results: In 51.6% of patients, surgery failed to achieve optimal debulking. The overall two and four year post-diagnosis survival rates were 28.7% and 9.4%, respectively. Uni-variate analysis revealed patient age, stage, histopathology, residual tumor, chemotherapy administration, but not the regimen and treatment completeness, impact patient survival. Multivariate analysis showed cancer stage (HR = 1.3, p = 0.04), and chemotherapy (HR = 2.8, p = 0.01) affected survival rate. Conclusion: Advanced stage ovarian cancer has a poor survival rate, especially in older patients. In this study, the only factors that impacted patient survival were cancer stage and adjuvant chemotherapy. Complex cytoreductive surgery in advanced stage ovarian cancer should also be performed to improve patient survival.