Timing of recurrence and overall survival in epithelial ovarian cancer: A 10-year retrospective review

Background: The timing of recurrence of epithelial ovarian cancer (EOC) after a standard primary treatment is an important indicator of the degree of response of the tumour to treatment. It, however, remains unclear if the timing of recurrence will predict survival outcomes. Aim: This study explored the impact of timing of recurrence after an initial response to standard primary treatment on the overall survival (OS) of patients with EOC. Methods: Data was extracted from the records of patients who underwent standard primary treatment and follow-up after EOC diagnosis between January 2011 and December 2020. The Kaplan-Meier survival estimates and Cox proportional hazards model adjusted for covariates were used for analyses. Results: The risks of recurrence of EOC increased steadily with increasing time from the start of primary treatment from 13.6% in 6-months to 71.0% after 12-months. In the final multivariate analyses, recurrence within 6 months of treatment was a significant independent predictor of poor OS in EOC patients (hazard ratio=7.23, 95%CI: 3.87–13.51, P<0.01). Conclusion: Our study suggests that recurrence within 6-months is an important prognostic predictor of poor OS in EOC. Early tumour recurrence may be a useful surrogate of OS and thus this information should be considered in the design of future tailored randomized controlled trials. Future strategies to improve OS in EOC patients should focus on identifying effective measures to prevent early tumour recurrence.