Chemotherapy Improves Survival in Women with Stage I Ovarian Cancer

Cancer Connect

The results of a recent review published in the journal Cancer indicate that adjuvant treatment with platinum-based chemotherapy produces improved survival and reduced risk of recurrence in women with stage I ovarian cancer compared to surgery alone.

Ovarian cancer is a malignancy that arises from various different cells within the ovaries. Approximately 25,000 new cases of ovarian cancer are diagnosed in the United States each year. Unfortunately, ovarian cancer often goes undetected until the disease has progressed into the abdomen or spread to other organs. The best treatment strategy for cancer is to prevent its occurrence or to detect it early when it is most treatable.

Stage I ovarian cancer refers to cancer that is confined to the ovaries and has not spread to other sites in the body. Controversy has existed over whether treatment including chemotherapy following surgery, referred to as adjuvant therapy, would improve outcomes in women with stage I ovarian cancer, compared to surgery alone. The concept behind adjuvant therapy is to kill any undetectable cancer cells that may remain in the body following surgery. These cells are responsible for cancer recurrences. Unfortunately, the evaluation of adjuvant therapy in women with this disease has been hindered by non-standardized surgical procedures, with some surgeons practicing much more diligent surgical techniques and more extensive removal of surrounding tissue and lymph nodes than others. Researchers continue to evaluate the effects of adjuvant chemotherapy on long-term outcomes in women with early ovarian cancer.

This recent study included evaluation of prior randomized studies conducted between 1965 and 2004, which compared various treatment approaches to stage I ovarian cancer. Eight trials compared adjuvant chemotherapy with no chemotherapy following surgery; however, many of the patients did not have lymph nodes removed as part of their surgical staging. The results of the studies were compiled and a benefit was shown in the women who received adjuvant chemotherapy. For patients with stage I ovarian cancer, chemotherapy was shown to improve survival rates by approximately 25%, as well as reduce the risk of disease recurrence by approximately 30%. Platinum-based chemotherapy (regimens containing cisplatin or carboplatin) was determined to improve overall 5-year survival.

Researchers concluded that these results add to growing evidence that women with stage I ovarian cancer have improved survival and a reduced risk of recurrent disease after receiving adjuvant platinum-based chemotherapy. Future studies will need to be conducted to determine the role of chemotherapy in women who have had adequate staging exams and who are found to have positive prognostic features. Patients with stage I ovarian cancer are encouraged to speak to their physician about their individual risks and benefits of treatment with adjuvant chemotherapy.

Reference: Elit L, Chambers A, Fyles A. et al Systematic review of adjuvant care for women with stage I ovarian carcinoma. Cancer. 27 September 2004. Published online at:

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Comments (1)
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I also study a case of the post-surgery chemotherapy for early stage of the epithelial ovarian cancer. In my thesis paper at I mentioned several key points which influence the laboratory results and are the main features in the post-surgery treatment. There's also a Korea Central Cancer Registry that analyzed the case studies between 1995 and 2014. Later the results were published on in the section Biomedical students' research papers.

Changes in ovarian cancer survival during the 20 years before the era of targeted therapy
Changes in ovarian cancer survival during the 20 years before the era of targeted therapy

The survival of patients with ovarian cancer has improved because of surgery and chemotherapy. This study aimed to estimate the changes in survival rates among Korean women with ovarian cancer prior to the introduction of targeted therapy for ovarian cancer. Data were obtained from the Korea Central Cancer Registry regarding patients who were diagnosed with epithelial ovarian cancer between 1995 and 2014. The relative survival rates were calculated for 5-year periods using the Ederer II method. Cox proportional hazard models were created to assess the associations of demographic and clinicopathological factors with ovarian cancer survival. During the study period, 22,880 women were diagnosed with epithelial ovarian cancer. The 5-year relative survival rate improved from 57.2% during 1995–1999 to 63.8% during 2010–2014 (P < 0.001). Survival outcomes improved between 1995 and 1999 and 2010–2014 for the serous and endometrioid carcinoma subtypes (P < 0.001). However, no improvements were observed for the mucinous and clear cell carcinoma subtypes (P = 0.189 and P = 0.293, respectively). Multivariate analysis revealed that younger age, early stage, recent diagnosis, primary surgical treatment, and non-serous histological subtype were favorable prognostic factors. Survival outcomes have improved for serous and endometrioid epithelial ovarian cancer in the last 20 years. However, no improvement was observed for patients with mucinous and clear cell carcinoma subtypes.

Ovarian Cancer