The National Cancer Data Base report on ovarian cancer. American College of Surgeons Commission on Cancer and the American Cancer Society.

BACKGROUND

Reports generated from the National Cancer Data Base (NCDB), a joint project of the American College of Surgeons Commission of Cancer and the American Cancer Society, have described trends in demographics, stage, treatment patterns, and survival for a variety of cancers. In this report, the most current (1991) data for ovarian cancer are presented and include some comparisons with 1985/1986 data.

METHODS

Three calls for data from hospital registries across the United States have yielded 17,114 ovarian cancer cases for 1985, 1986, and 1991 combined. These data represent approximately 23%, 23%, and 43%, respectively, of the annual number of cases of ovarian cancer in the United States for those years.

RESULTS

One-fourth of the reported cases of ovarian cancer were diagnosed in women less than 50 years of age. Younger patients (< 40 years) were more likely to have received conservative therapy (unilateral oophorectomy), consistent with their high prevalence (59%) of Stage I disease. The number of patients reported with an unknown American Joint Committee on Cancer (AJCC) stage decreased from 49% in 1985/1986 to 17% in 1991, although the distribution within stages was unchanged. Increases in important staging procedures were reported in 1991, with threefold increase in the proportion of debulking procedures 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 Stage IV. Asians and Hispanics presented with a relatively high rate of Stage I-II disease (45%) compared with non-Hispanic whites and African Americans (38% and 33%, respectively). Hispanics presented with the most favorable Stage I/IV ratio (1.5) and had an overall 5-year survival of 50% compared with 41% and 37% for non-Hispanic whites and African Americans (Stage I/IV ratios of 1.0 and 0.7, respectively). There was little difference reported in the use of multimodality treatment between 1985/1986 and 1991.

CONCLUSIONS

A trend toward more complete surgery with full surgical/pathologic staging was observed in 1991, but there was not yet evidence to indicate significant improvements in ovarian cancer survival compared with published figures during the past 10-15 years. Important ethnic and demographic differences in type of surgery and survival were noted but could not be differentiated from differences in tumor stage.