Parity as a Prognostic Factor in Patients with Advanced-Stage Epithelial Ovarian Cancer

• Main Authors: Khalafi-Nezhad A, Ebrahimi V, Ahmadpour F, Momtahan M, Robati M, Saraf Z, Ramzi M, Jowkar Z, Ghaffari P
• Format: Article
• Language: English
• Published: Dove Medical Press 2020-02-01
• Series: Cancer Management and Research
• Subjects: advanced-stage epithelial ovarian cancer; early-stage epithelial ovarian cancer; parity; overall survival; stratified cox-adjusted regression.
• Online Access: https://www.dovepress.com/parity-as-a-prognostic-factor-in-patients-with-advanced-stage-epitheli-peer-reviewed-article-CMAR

Abolfazl Khalafi-Nezhad,1 Vahid Ebrahimi,2 Fatemeh Ahmadpour,3 Mozhdeh Momtahan,3 Minoo Robati,3 Zahra Saraf,3 Mani Ramzi,1 Zahra Jowkar,4 Parvin Ghaffari5 1Hematology Research Center, Department of Hematology, Medical Oncology and Stem Cell Transplantation, Shiraz University of Medical Sciences, Shiraz, Iran; 2Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; 3Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; 4Oral and Dental Disease Research Center, Department of Operative Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran; 5Department of Obstetrics and Gynecology, School of Medicine, Yasuj University of Medical Sciences, Yasuj, IranCorrespondence: Abolfazl Khalafi-NezhadDepartment of Hematology, Medical Oncology and Stem Cell Transplantation, Shiraz University of Medical Sciences, Shiraz, IranTel/Fax [phone]Email [e-mail] AhmadpourDepartment of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranTel/Fax [phone]Email [e-mail]: This study aimed to determine the prognostic factors influencing the overall survival (OS) of Iranian women with epithelial ovarian cancer (EOC).Methods: Information about newly diagnosed patients with confirmed EOC at Motahari Clinic, Shiraz, Iran, from January 1, 2001, to December 31, 2016, was retrospectively reviewed and analyzed. Cox-adjusted proportional hazards (PH) and stratified Cox (SC) models were used to determine the potential prognostic factors.Results: The mean (±SD) age at the diagnosis of 385 patients with EOC was 49.0 (± 13.2) years old. Early-stage EOC (ESEOC) and advanced-stage EOC (ASEOC) were diagnosed in 34.3% and 65.7% of the total patients, respectively. The median (95% CI) OS was 35 (28− 41) months. For ESEOC patients, a stage II-tumor led to a lower OS in the multivariable analysis compared to a lower stage tumor (P= 0.025). For ASEOC patients, age≥ 65 years at diagnosis (P=0.008) led to a lower OS. ASEOC patients with 2– 5 parities (P=0.014) and > 5 parity (P=0.001) demonstrated better OS than nulliparous women.Conclusion: Patients with ESEOC, higher tumor stage was associated with a shorter OS. The age at diagnosis harmed the OS of patients with ASEOC. More than one parity improved OS in ASEOC patients.Keywords: advanced-stage epithelial ovarian cancer, early-stage epithelial ovarian cancer, parity, overall survival, stratified Cox-adjusted regression