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Published on: January 26, 2024
Symptoms of Women With High-Risk Early-Stage Ovarian Cancer
John K Chan1, Chunqiao Tian, Joshua P Kesterson
1Palo Alto Medical Foundation/California Pacific/Sutter Research Institute, Palo Alto, California; NRG Oncology, Clinical Trial Development Division, Biostatistics & Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, New York; Penn State Hershey Medical Center, Hershey, Pennsylvania; Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine at St. Joseph's Hospital, Phoenix, Arizona; Stanford University School of Medicine, Stanford, California; Duke University, Durham, North Carolina; Indiana University, Indianapolis, Indiana; The Ohio State University Medical Center, Columbus Ohio; Oklahoma University Hospital, Stephenson Cancer Center, Oklahoma City, Oklahoma; Moffitt Cancer Center, Tampa, Florida; Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, Bethesda, Maryland; Women's Cancer Center of Nevada, Las Vegas, Nevada; University of California at Irvine, Irvine, California; and Riverside Methodist Hospital, Columbus, Ohio.
Objective:
To assess the presentation, characteristics, and prognostic significance of symptoms in patients with high-risk early-stage epithelial ovarian cancer.
Methods:
A retrospective chart review was performed on all patients enrolled in a phase III clinical trial (GOG 157). All patients had surgically staged, high-risk early-stage epithelial ovarian cancer (stage IA-IB and grade 3, any clear cell, stage IC or II). Chi-square and Kaplan-Meier estimates and Cox proportional hazards models were used for statistical analyses.
Results:
Of 419 patients evaluated for symptoms, 301 (72%) presented with one or more symptoms, and 118 (28%) were asymptomatic but had a mass found on examination. Forty percent had only one symptom, and 32% had more than one symptom. Among those with at least one symptom, the most common were abdominal and pelvic pain (31%), and increased girth or fullness (26%). Overall, 23% of patients with tumors 10 cm or smaller, 27% of patients with tumors larger than 10 cm to 15 cm, and 46% of patients with tumors larger than 15 cm had multiple symptoms (P<.001). There was no significant difference in presentation of symptoms based on age, stage, or histologic subtype. Symptoms at diagnosis were not associated with recurrence or survival.
Conclusion:
More than 70% of patients with high-risk early-stage, epithelial ovarian cancer present with one or more symptoms, with the most common being abdominal or pelvic pain. The proportion of women with symptoms and the number of symptoms increase with enlarging tumor size.
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