title: Patterns and progress in ovarian cancer over 14 years.
abstract: OBJECTIVE
  To estimate the change in survival rates of women with ovarian cancer during the past 14 years.
  
  
  METHODS
  Women diagnosed with epithelial, germ cell, sarcomas, and sex-cord stromal ovarian tumors were identified from the Surveillance Epidemiology and End Results Database. Demographic and clinicopathologic factors, and survival information were extracted and tested using chi 2 and Kaplan-Meier and Cox regression analyses.
  
  
  RESULTS
  A total of 30,246 women were diagnosed with ovarian cancer, including 26,753 non-clear cell epithelial, 1,411 clear cell, 818 sarcoma, 778 germ cell, and 486 sex-cord stromal tumors. The 5-year disease-specific survival rate across 1988-1992 and 1993-1997 improved from 45.4% to 48.6% (P < .001). The corresponding estimates show increases for non-clear cell epithelial carcinoma from 42.5% to 45.8% (P < .001), and for sarcomas from 33.5% to 38.8% (P = .07). However, improvements were not observed in those with clear cell, 64.3% to 63.9% (P = .82), and sex-cord stromal, 89.7% to 85.7% (P = .18), tumors of the ovary. In multivariable analyses, younger age, early stage, favorable histologic cell types, low-grade tumors, standard surgery, and recent time interval from 1993-1997 were independent prognostic factors for improved survival.
  
  
  CONCLUSIONS
  In this large population-based study, there has been some improvement in the overall survival of women with ovarian cancers during a 14-year period. However, new treatment strategies are warranted for those with epithelial cancer and sarcomas of the ovary, given their overall poor prognosis. These results from our updated analyses might help to counsel women diagnosed with ovarian cancers.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford Cancer Center, Stanford, California 94305, USA. johnchan@stanford.edu
authors.forename: John K
authors.initials: JK
authors.lastname: Chan
authors.forename: Michael K
authors.initials: MK
authors.lastname: Cheung
authors.forename: Amreen
authors.initials: A
authors.lastname: Husain
authors.forename: Nelson N
authors.initials: NN
authors.lastname: Teng
authors.forename: Dee
authors.initials: D
authors.lastname: West
authors.forename: Alice S
authors.initials: AS
authors.lastname: Whittemore
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Berek
authors.forename: Kathryn
authors.initials: K
authors.lastname: Osann
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000453:epidemiology / Q000401:mortality; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000453:epidemiology* / Q000401:mortality; D009375:Neoplasms, Glandular and Epithelial / Q000453:epidemiology* / Q000401:mortality; D010051:Ovarian Neoplasms / Q000453:epidemiology* / Q000401:mortality; D011379:Prognosis; D016016:Proportional Hazards Models; D012509:Sarcoma / Q000453:epidemiology* / Q000401:mortality; D018312:Sex Cord-Gonadal Stromal Tumors / Q000453:epidemiology* / Q000401:mortality; D015996:Survival Rate; D014481:United States / Q000453:epidemiology