Abstract
OBJECTIVES:
Epithelial
ovarian cancer (EOC) is an aggressive disease in which first line
therapy consists of a surgical staging/debulking procedure and platinum
based chemotherapy. There is significant interest in clinically
applicable, easy to use prognostic tools to estimate risk of recurrence
and overall survival. In this study we used a large prospectively
collected cohort of women with EOC to validate currently published
models and assess prognostic variables.
METHODS:
Women
with invasive ovarian, peritoneal, or fallopian tube cancer diagnosed
between 2000-2011 and prospectively enrolled into the Mayo Clinic
Ovarian Cancer registry were identified. Demographics and known
prognostic markers as well as epidemiologic exposure variables were
abstracted from the medical record and collected via questionnaire. Six
previously published models of overall and recurrence-free survival were
assessed for external validity. In addition, predictors of outcome were
assessed in our dataset.
RESULTS:
Previously
published models validated with a range of c-statistics (0.587-0.827),
though application of models containing variables not part of routine
practice were somewhat limited by missing data; utilization of all
applicable models and comparison of results is suggested. Examination of
prognostic variables identified only the presence of ascites and ASA
score to be independent predictors of prognosis in our dataset, albeit
with marginal gain in prognostic information, after accounting for stage
and debulking.
CONCLUSIONS:
Existing
prognostic models for newly diagnosed EOC showed acceptable calibration
in our cohort for clinical application. However, modeling of
prospective variables in our dataset reiterates that stage and debulking
remain the most important predictors of prognosis in this setting.
0 comments :
Post a Comment
Your comments?
Note: Only a member of this blog may post a comment.