Prognostic Factors Associated With Overall Survival In Presumed Early Stage, High-Grade Serous Ovarian Cancer: An Analysis Of The Seer Cancer Database

Objectives: To evaluate how lymphadenectomy, chemotherapy, and patient-related factors impact overall survival in early stage, high grade serous ovarian cancer using the SEER cancer database. Methods: Ovarian cancer cases in the SEER cancer database from the years 2004-2016 were used in this analysis. Cases were limited to grade 3 or 4, stage T1 disease with serous histology. To account for possible miscoding of cases, those with metastatic disease, positive lymph node evaluation, or with an AJCC stage group of II, III, or IV were removed from the analysis. Survival analysis was completed using the Kaplan-Meier method and the Cox proportional hazards regression model to evaluate for possible factors affecting overall survival. Statistical analysis and plot creation was conducted in R using the ‘survminer’ and ‘survival’ packages. Results: A total of 1052 early stage, high grade serous ovarian cancer cases were evaluated using the SEER database. Survival at 5-years and 10-years was 84.1% and 74.0%, respectively. Median follow-up time was 69 months. Not having lymphadenectomy performed with unknown nodal status was associated with worse overall survival (HR: 3.0, p Conclusions: Lack of lymphadenectomy and Black race are prognostic factors associated with worse overall survival in presumed early-stage, high grade serous ovarian cancer regardless of receipt of chemotherapy.