Population-based study of survival for women with serous cancer of the ovary, fallopian tube, peritoneum or undesignated origin - on behalf of the Swedish gynecological cancer group (SweGCG).
OBJECTIVE
The aim of the study was to determine survival outcome in patients with serous cancer in the ovary, fallopian tube, peritoneum and of undesignated origin.


METHODS
Nation-wide population-based study of women≥18years with histologically verified non-uterine serous cancer, included in the Swedish Quality Registry for primary cancer of the ovary, fallopian tube and peritoneum diagnosed 2009-2013. Relative survival (RS) was estimated using the Ederer II method. Simple and multivariable analyses were estimated by Poisson regression models.


RESULTS
Of 5627 women identified, 1246 (22%) had borderline tumors and 4381 had malignant tumors. In total, 2359 women had serous cancer; 71% originated in the ovary (OC), 9% in the fallopian tube (FTC), 9% in the peritoneum (PPC) and 11% at an undesignated primary site (UPS). Estimated RS at 5-years was 37%; for FTC 54%, 40% for OC, 34% for PPC and 13% for UPS. In multivariable regression analyses restricted to women who had undergone primary or interval debulking surgery for OC, FTC and PPC, site of origin was not independently associated with survival. Significant associations with worse survival were found for advanced stages (RR 2.63, P<0.001), moderate (RR 1.90, P<0.047) and poor differentiation (RR 2.20, P<0.009), neoadjuvant chemotherapy (RR1.33, P<0.022), residual tumor (RR 2.65, P<0.001) and platinum single (2.34, P<0.001) compared to platinum combination chemotherapy.


CONCLUSIONS
Survival was poorer for serous cancer at UPS than for ovarian, fallopian tube and peritoneal cancer. Serous cancer at UPS needs to be addressed when reporting and comparing survival rates of ovarian cancer.
Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden. Electronic address: pernilla.dahm-kahler@vgregion.se.
Pernilla
P
Dahm-Kähler
Department of Obstetrics and Gynecology, Skane University Hospital, Lund University, Lund, Sweden.
Christer
C
Borgfeldt
Regional Cancer Center Western Sweden, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Erik
E
Holmberg
Regional Cancer Center Western Sweden, Sahlgrenska University Hospital, Gothenburg, Sweden.
Christian
C
Staf
Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
Henrik
H
Falconer
Department of Clinical Sciences, Skane University Hospital, Lund, Sweden.
Maria
M
Bjurberg
Department of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Preben
P
Kjölhede
Department of Oncology, University Hospital Linköping, Linköping, Sweden.
Per
P
Rosenberg
Department of Women's and Children's health Uppsala University, Uppsala, Sweden.
Karin
K
Stålberg
Department of Cancer Epidemiology, Lund University, Lund, Sweden.
Thomas
T
Högberg
Department of Oncology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.
Elisabeth
E
Åvall-Lundqvist
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D065426:Cytoreduction Surgical Procedures; D005185:Fallopian Tube Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D009382:Neoplasms, Unknown Primary / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D010051:Ovarian Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D010534:Peritoneal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D017671:Platinum Compounds / Q000627:therapeutic use; D012042:Registries; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
D017671:Platinum Compounds
Cancer origin; Ovarian cancer; Serous cancer; Survival