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Prognosis and survival for ovarian cancer
Women with ovarian cancer may have questions about their prognosis and survival. Prognosis and survival depend on many factors. Only a doctor familiar with a person’s medical history, type of cancer, stage, characteristics of the cancer, treatments chosen and response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognosis is the doctor’s best estimate of how cancer will affect a person and how it will respond to treatment. A prognostic factor is an aspect of the cancer or a characteristic of the person that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together and they both play a part in deciding on a treatment plan and a prognosis.
The following are prognostic and predictive factors for ovarian cancer.
Stage is the most important prognostic factor for most types of ovarian cancer. Women diagnosed with early stage ovarian cancer have a more favourable prognosis than women diagnosed with advanced stages.
Cancer cells in ascites or peritoneal washings
If ovarian cancer cells are found in ascites (abnormal buildup of fluid in the abdomen) or the washings of the peritoneum taken during surgery, the prognosis is less favourable.
Ovarian tumours can cause small tumours to spread to and grow on organs throughout the pelvis and abdomen. If there are a large number of tumours within the pelvis and abdomen, the prognosis is less favourable.
The grade of the cancer is an important prognostic factor for ovarian cancer. Low-grade tumours are associated with a more favourable prognosis than high-grade tumours.
Tumour can be removed
Ovarian cancer found in the abdomen and pelvis that is completely removed, with no cancer cells present in the margins around the tumour, has a more favourable prognosis. The more cancer that is removed with surgery, the better the prognosis.
Some types of ovarian cancer have a more favourable prognosis. The characteristics of a particular type of tumour often relate to the grade or stage of the tumour. For example, most ovarian stromal tumours are low grade and have a good prognosis. Tumours of borderline malignancy often occur in earlier stages and have a favourable prognosis.
Tumours in younger women have a more favourable prognosis than tumours in older women.
Performance status is a measure of how well a person is able to perform ordinary tasks and carry out daily activities. A woman with a good performance status is more likely to respond to treatment, experience fewer and less severe side effects and have a more favourable prognosis.
Response to chemotherapy
Achieving a complete remission after the first cycle of chemotherapy is considered a favourable prognostic factor.
Cancer antigen 125 (CA125) level
A lowered level of CA125 after chemotherapy indicates a good response to treatment and is a favourable prognostic factor.
Other prognostic factors
Some prognostic factors are related to specific types of tumours.
- For epithelial tumours, an abnormal number of chromosomeschromosomesThe part of a cell that contains DNA (genetic information). (aneuploidy) in the ovarian cancer cells may suggest that the tumour is more aggressive with a less favourable prognosis.
- If a stromal tumour breaks open (ruptures), the prognosis is less favourable. However, a tumour that ruptures during surgery does not appear to affect prognosis. Stromal tumours found in both ovaries also have a less favourable prognosis.