Hidden in plain sight - Survival consequences of baseline symptom burden in women with recurrent ovarian cancer

Area of Science:

• Oncology
• Palliative Care
• Clinical Research

Background:

• Recurrent ovarian cancer (ROC) presents a significant symptom burden for patients.
• Understanding baseline symptom burden is critical for predicting treatment outcomes.

Purpose of the Study:

• To describe the baseline symptom burden (SB) in patients with recurrent ovarian cancer (ROC).
• To investigate the association between SB and progression-free survival (PFS) and overall survival (OS).

Main Methods:

• Analysis of baseline SB in patients with platinum-resistant/refractory ROC (PRR-ROC) or potentially platinum-sensitive ROC (PPS-ROC≥3) from the GCIG-SBS study.
• Utilized the Measure of Ovarian Symptoms and Treatment concerns (MOST) tool.
• Correlated symptom severity with PFS and OS.

Main Results:

• 948 patients reported substantial baseline SB, with high prevalence of pain (80%), abdominal symptoms (75%), shortness of breath (60%), and fatigue (90%).
• Significant proportions reported moderate to severe anxiety (50%) and depression (35%).
• Higher SB strongly correlated with significantly shortened PFS and OS; five specific symptoms (trouble eating, vomiting, indigestion, loss of appetite, nausea) showed OS hazard ratios >2 (p<0.001).

Conclusions:

• Patients with ROC exhibit high baseline SB before palliative chemotherapy, consistent across PRR-ROC and PPS-ROC≥3 subgroups.
• Elevated SB is a strong predictor of early progression and mortality.
• Active management of SB is recommended, and it should be incorporated for patient stratification in clinical trials, with emphasis on reporting treatment impact on symptom control.