Prognostic factors in early-onset epithelial ovarian cancer: A population-based study

Objective: To investigate the clinical prognostic factors that influence ov arian cancer survival in women with early-onset epithelial ovarian cancer u sing population-based data. Methods: Subjects in the current study were from a population-based series of 197 patients with invasive ovarian cancer and 60 patients with ovarian c ancer of low malignant potential who were identified from the Cancer and St eroid Hormone study. All subjects were between 20 and 54 years of age at di agnosis for ovarian cancer. Epidemiologic data were obtained from each part icipant. Immunohistochemical staining was performed to assess p53 expressio n in paraffin-embedded ovarian cancers. Univariate and multivariate analyse s for survival were conducted using the proportional hazards model to test the prognostic significance of several clinicopathologic factors among subj ects. Results: Among women with invasive tumors, the proportional hazards model r evealed that advanced stage at diagnosis [hazard ratio = 4.1, 95% confidenc e interval (CI) = 2.5, 6.6], age at diagnosis 46-54 (hazard ratio = 2.0, 95 % CI = 1.3, 3.0), and overexpression of p53 (hazard ratio = 1.5, 95% CI = 1 .1, 2.3) were significantly associated with decreased survival. Conclusion: These results provide evidence that stage, age, and P53 overexp ression are independent predictors of decreased survival in women with inva sive ovarian cancer diagnosed younger than age 55. Further investigation of the effect of age at diagnosis on the relationship between p53 overexpress ion and ovarian cancer survival is warranted. (Obstet Gynecol 2000;95:119-2 7. (C) 2000 by The American College of Obstetricians and Gynecologists.).