Survival in ovarian cancer patients by histology and family history

Abstract

Introduction. Earlier studies suggest that histology has no prognostic significance in patients with invasive ovarian tumors. Studies about the effect of family history on survival have given conflicting results, which we try to clarify in this study. As an additional question, we examined whether family members share survival experience. Methods. We used the nation-wide Swedish Family-Cancer Database to estimate hazard ratios (HRs) for cause-specific and overall survival in ovarian cancer patients by histology and family history. HRs show the probability of death in the study group compared to the reference group. Results. A total of 6 049 ovarian cancer patients with specific histologies were retrieved from our Database from years 1993 to 1999. Compared to women with epithelial ovarian cancer, women with borderline epithelial tumors had the best survival (HR 0.02 and 0.14 for cause-specific and overall survival). Good survival was also noted for patients with sex cord-stromal tumors and germ cell tumors. Among specific subtypes of epithelial ovarian cancers, good survival was noted for women with clear cell and endometrioid carcinomas and mucinous cystadenocarcinoma. The study covered 80 mother-daughter pairs with a family history. Patients with a family history had a poorer survival than sporadic cases in both maternal and offspring generations. When the survival was analyzed according to the probands’ length of survival, there was a non-significant concordance of prognosis. Conclusion. Our data showed that histology and family history are prognostic factors for ovarian tumors. Patients with a family history had a more aggressive course than the sporadic cases.