THE NATIONAL-CANCER-DATA-BASE REPORT ON OVARIAN-CANCER

Background. Reports generated from the National Cancer Data Base (NCDB ), a joint project of the American College of Surgeons Commission on C ancer and the American Cancer Society, have described trends in demogr aphics, stage, treatment patterns, and survival for a variety of cance rs. In this report, the most current (1991) data for ovarian cancer ar e presented and include some comparisons with 1985/1986 data. Methods. Three calls for data from hospital registries across the United State s have yielded 17,114 ovarian cancer cases for 1985, 1986, and 1991 co mbined. These data represent approximately 23%, 23%, and 43%, respecti vely, of the annual number of cases of ovarian cancer in the United St ates for those years. Results. One-fourth of the reported cases of ova rian cancer were diagnosed in women less than 50 years of age. Younger patients (<49 years) were more likely to have received conservative t herapy (unilateral oophorectomy), consistent with their high prevalenc e (59%) of Stage I disease. The number of patients reported with an un known American Joint Committee on Cancer (ATCC) stage decreased from 4 9% in 1985/1988 to 17% in 1991, although the distribution within stage s was unchanged. Increases in important staging procedures were report ed in 1991, with threefold increase in the proportion of debulking pro cedures and a 50% increase in omentectomies accompanying hysterectomy compared with 1985/1986. More advanced disease was reported for those of older age, lower income, African Americans, and patients in smaller hospitals. Relative 5-year survival rates were 74% for patients with Stage I disease, 58% for Stage II, 30% for Stage III, and 19% for Stag e IV. Asians and Hispanics presented with a relatively high rate of St age II-I disease (45%) compared with non-Hispanic whites and African A mericans (38% and 33%, respectively). Hispanics presented with the mos t favorable Stage I/IV ratio (1.5) and had an overall B-year survival of 50% compared with 41% and 37% for non-Hispanic whites and African A mericans (Stage I/IV ratios of 1.0 and 0.7, respectively), There was l ittle difference reported in the use of multi-modality treatment betwe en 1985/1986 and 1991. Conclusions. A trend toward more complete surge ry with full surgical/pathologic staging was observed in 1998, but the re was not yet evidence to indicate significant improvements in ovaria n cancer survival compared with published figures during the past 10-1 5 years, Important ethnic and demographic differences in type of surge ry and survival were noted but could not be differentiated from differ ences in tumor stage.