title: Prognostic significance of residual tumor in patients with epithelial ovarian carcinoma stage IV in a 20 year perspective.
abstract: OBJECTIVE
  We aimed to evaluate prognostic factors impacting on overall survival during a 20 year period with substantial changes in surgical approach and chemotherapy management of patients with epithelial ovarian carcinoma stage IV.
  
  
  METHODS
  A retrospective population-based study.
  
  
  METHODS
  The Norwegian Radium Hospital during 1985-2005.
  
  
  METHODS
  Three hundred and ninety-four patients with epithelial ovarian carcinoma stage IV treated at the Norwegian Radium Hospital.
  
  
  METHODS
  The cohort was divided into two groups (1985-1995 and 1996-2005), and clinical and pathological characteristics were compared. Univariate and multivariate analyses were performed to identify prognostic factors during 1985-1995, 1996-2005 and 1985-2005.
  
  
  METHODS
  Prognostic factors and overall survival in the three periods.
  
  
  RESULTS
  Median overall survival improved from 1985-1995 to 1996-2005 (from 1.3 to 2.1 years). More patients had macroscopic radical surgery (28 vs. 11%), received neoadjuvant chemotherapy and were treated with platinum-taxane combination therapy from 1996-2005 compared to 1985-1995. Patients with primary surgery had improved median overall survival from 1996-2005 compared to 1985-1995. In multivariate analyses, surgical approach was not a prognostic factor for overall survival, but chemotherapy was during 1985-2005. Postoperative residual tumor was a prognostic factor for overall survival in all periods.
  
  
  CONCLUSIONS
  Macroscopic radical surgery is a strong prognostic factor for overall survival and is achievable in a subset of patients with epithelial ovarian carcinoma stage IV. Improved selection criteria for what treatment algorithm to choose for patients with epithelial ovarian carcinoma stage IV are warranted.
authors: Department of Obstetrics and Gynecology, Baerum Hospital, Norway.
authors: Mari B
authors: MB
authors: Elstrand
authors: Berit
authors: B
authors: Sandstad
authors: Halldis
authors: H
authors: Oksefjell
authors: Ben
authors: B
authors: Davidson
authors: Claes G
authors: CG
authors: Tropé
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000077216:Carcinoma, Ovarian Epithelial; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000401:mortality*; D009375:Neoplasms, Glandular and Epithelial / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D010051:Ovarian Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016896:Treatment Outcome