Prognostic Factors of Non-epithelial Ovarian Cancer in a Tertiary Hospital in Indonesia

Abstract

Introduction: Non-epithelial is a rare type of ovarian cancer but the most common ovarian neoplasm in reproductive age. This study analyzed the correlation of clinical characteristics to disease-free survival (DFS) and 3-year survival in non-epithelial ovarian cancer. Methods: A cohort analysis of medical records of 30 patients with non-epithelial ovarian cancer from 2016 to 2017 at Dr. Soetomo General Academic Hospital. Survival analysis was performed using Kaplan–Meier test, log-rank test, and Cox regression to determine the correlation of characteristics including age, stage, tumor size, tumor residue, histopathology type and chemotherapy status as prognostic factors for recurrence and mortality. Results: DFS was significantly affected by stage (p=0.049), tumor residue (p<0.0001), and chemotherapy (p=0.005). Stage I, no residual disease, and adequate chemotherapy had the highest DFS and mean DFS rates (94.1% and 35.6 months; 95.5% and 35.7 months; 75% and 31.94 months, respectively). Highest recurrence rates were found in patients with unstaged disease (hazard ratio [HR]=10.08), residue >0 cm (HR=23.13), and inadequate chemotherapy (HR=6.55). Three-year survival was significantly affected by stage (p=0.001), tumor residue (p<0.0001), and chemotherapy (p<0.0001). Stage I, no residual disease, and adequate chemotherapy had the highest 3-year survival rate and mean survival time (94.1% and 35.47 months; 95.5% and 35.7 months; 87.5% and 33 months). The highest mortality were found in patients with unstaged disease (HR=19.99), residue >0 cm (HR=11.33), and inadequate chemotherapy (HR=11.71). Conclusion: Stage, tumor residue, and chemotherapy status in patients with non-epithelial ovarian cancer are significant prognostic factors for DFS and 3-year survival.