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04.12.2013 admin
When you are told you have ovarian cancer and begin looking for treatment options, you may be concerned about life expectancy and quality of life.
How do you decide where to go for treatment after you have been diagnosed with ovarian cancer? The chart below shows the survival results of 25 advanced-stage ovarian cancer patients who were diagnosed between 2004 and 2008.
Survival rates are also meaningful when compared to the results of other treatment centers.
As an alternative, we asked the independent biostatistician to analyze and compare our ovarian cancer rates to national cancer survival statistics that are gathered by the National Cancer Institute (NCI). The chart below shows a comparison between CTCA and SEER on the survival rates of advanced-stage, ovarian cancer patients who were diagnosed between 2000 and 2005. As you study the chart, it’s important to remember that the estimated CTCA survival rates were based on a relatively small sample of 28 advanced-stage ovarian cancer patients and therefore were subject to a high degree of variation. The chart below shows the cancer survival rates for a group of 126 metastatic ovarian cancer patients who were diagnosed between 2000 and 2011. Of the CTCA metastatic ovarian cancer patients shown in the above chart, the estimated survival rate at six months was 93%. At Cancer Treatment Centers of America, we understand that you may also wish to see the survival rates of the group of metastatic ovarian cancer patients reported in the Surveillance, Epidemiology and End Results (SEER) database of the National Cancer Institute. Therefore, we asked an independent biostatistician to analyze both the survival rates of the group of CTCA patients and the group of patients included in the SEER database. The objective of this analysis was to see how long each group of patients survived after their diagnosis. We also want to be sure you understand that cancer is a complex disease and each person’s medical condition is different; therefore, CTCA makes no claims about the efficacy of specific treatments, the delivery of care, nor the meaning of the CTCA and SEER analyses. This analysis included ovarian cancer patients from CTCA who were diagnosed from 2000 to 2011 (including 2000 and 2011) with a primary tumor site (as coded by ICD-O-2 (1973+)) of C569, and were considered analytic cases by the CTCA. Primary tumor sites (as coded by ICD-O-2 (1973+)), date of initial diagnosis, date of last contact, year of initial diagnosis, age of initial diagnosis, gender, vital status, and cancer histologic type as coded by the ICD-O-3.
The database from the CTCA cohort was prepared by the CTCA cancer registrars from the following four hospitals: Southwestern Regional Medical Center hospital, Midwestern Regional Medical Center hospital, Eastern Regional Medical Center hospital, and Western Regional Medical Center hospital. The SEER program of the National Cancer Institute is an authoritative source of information on cancer incidence and survival in the United States. This analysis included ovarian cancer patients from the latest SEER Limited-Use Database (as of 2014) who were diagnosed from 2000 to 2011 (including 2000 and 2011) with a primary tumor site (as coded by ICD-O-2 (1973+)) of C569.
Primary tumor sites (as coded by ICD-O-2 (1973+)), survival time recode as calculated by the date of initial diagnosis and the date of death or the follow-up cutoff date, year of initial diagnosis, age of initial diagnosis, gender, vital status, and cancer histologic type as coded by the ICD-O-3. In order to make a meaningful survival analysis, basic cancer and patient characteristics such as age at initial diagnosis, year of initial diagnosis, cancer stages, and cancer primary sites were first analyzed for both the CTCA and SEER samples. For example, if a specific primary tumor site had patients in only one database, none of those patients were used in the analysis. The survival outcome from the CTCA database was defined as the time from the initial diagnosis to death and computed in number of years as the difference between the date of death and the date of initial diagnosis divided by 365.25. For each survival outcome from each database, the survival curve, defined as the probability of cancer patient survival as a function of time after the initial diagnosis, was estimated by the nonparametric product-limit method[1].
Covariates such as age at initial diagnosis and year of initial diagnosis could affect the survival of ovarian cancer patients. We understand you may be feeling overwhelmed with questions and concerns about your type of cancer and what it all means. Explore our cancer hospitals, which house the latest treatments, technologies and integrative oncology services under one roof.
Discover our patient-centered approach, and how you get all your questions answered in a single visit by a dedicated team of cancer experts.
Our Pathology Division is one of the few clinical services globally with a team of pathologists and researchers who focus entirely on gynecologic cancers, with thousands of diagnoses each year.
Epithelial: This is the most common type of ovarian cancer, which starts in the epithelium tissue, the lining on the outside of the ovary or in the fallopian tube. Sex cord stromal: These rare tumors grow in the connective tissue that holds the ovary together and makes estrogen and progesterone. Primary peritoneal carcinoma: This is a rare type of ovarian cancer that begins to form in the lining of the pelvis and abdomen and is treated identically to ovarian and fallopian tube cancer. Our diagnostic team provides second opinions, including for challenging or difficult cases. After our doctors carefully review your medical history and your familial risk of developing ovarian cancer, and complete a pelvic exam, they will conduct a combination of biopsies and imaging tests. Transvaginal ultrasound: a procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs, such as the vagina, uterus, fallopian tubes, and bladder. Blood test: a test to measure a substance in the blood called CA-125 (a tumor marker that is often found to be elevated in the blood of women with ovarian cancer). Biopsy: a procedure in which small samples of tissue or cells are removed from the ovary for examination under a microscope.
Fine-needle aspiration (FNA) biopsy or a core biopsy: The removal of tissue or fluid containing ovarian cells, using a thin needle. Approximately up to 20 percent of ovarian, fallopian tube, and peritoneal cancers are caused by inherited gene mutations, such as the BRCA1 and BRCA2 genes and Lynch syndrome.
Detecting a mutated gene does not mean that you will develop cancer, or that cancer is currently present. If you or your doctor thinks you are at high risk of developing ovarian cancer, the Cancer Genetics and Prevention Program at Dana-Farber can create a personalized program to accurately estimate your risk and work with you — together with your physicians and nurse practitioners — to lower your risk as much as possible.
If ovarian cancer is found after examining ovarian tissue samples, further tests are done to see if the cancer cells have spread within the ovaries or to other parts of the body. MRI (Magnetic Resonance Imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. Pretreatment surgical staging: Surgery is performed to find out if the cancer has spread within the ovaries or to other parts of the body.
Information from exams and diagnostic tests is used to determine the extent of the tumor, and whether or not the cancer has spread to the lymph nodes or other tissues.
Stage II means that cancer is found in one or both ovaries, as well as other areas in the pelvis. Stage III signifies cancer has spread beyond the ovaries and pelvis, to the abdomen (abdominal wall or small intestines) or nearby lymph nodes. Stage IV indicates that cancer has spread beyond the ovaries, abdomen, and pelvis to other parts of the body, such as the lungs, the liver, or other tissues. Ursula Matulonis, MD, Medical Director and Program Leader of Dana-Farber's Medical Gynecologic Oncology Program, answers patients' questions about uterine, ovarian, and cervical cancer. When you are told you have cancer and begin looking for treatment options, you may be concerned about life expectancy and quality of life.
The chart below shows the cancer survival rates of 232 metastatic breast cancer patients who were diagnosed between 2000 and 2009.
Of the CTCA metastatic breast cancer patients shown in the above chart, the estimated survival rate at six months was 95%.


SEER is the only authoritative source of population-based information about cancer incidence and survival in the United States that includes the stage of cancer at the time of diagnosis and patient survival data. The independent biostatistician computed the survival outcomes of metastatic breast cancer patients from the CTCA database and metastatic breast cancer patients from the SEER database who were diagnosed between 2000 and 2009. The chart below shows the cancer survival rates for a group of 323 metastatic breast cancer patients who were diagnosed between 2000 and 2011. At Cancer Treatment Centers of America, we understand that you may also wish to see the survival rates of the group of metastatic breast cancer patients reported in the Surveillance, Epidemiology and End Results (SEER) database of the National Cancer Institute. We also want to be sure you understand that cancer is a complex disease and each person's medical condition is different; therefore, CTCA makes no claims about the efficacy of specific treatments, the delivery of care, nor the meaning of the CTCA and SEER analyses. This analysis included breast cancer patients from CTCA who were diagnosed from 2000 to 2011 (including 2000 and 2011) with primary tumor sites (as coded by ICD-O-2 (1973+)) from C500 to C509, and were considered analytic cases by the CTCA. Primary tumor sites (as coded by ICD-O-2 (1973+)), date of initial diagnosis, date of last contact, year of initial diagnosis, age of initial diagnosis, vital status, and cancer histologic type as coded by the ICD-O-3. This analysis included breast cancer patients from the latest SEER Limited-Use Database (as of 2014) who were diagnosed from 2000 to 2011 (including 2000 and 2011) with primary tumor sites (as coded by ICD-O-2 (1973+)) from C500 to C509.
Primary tumor sites (as coded by ICD-O-2 (1973+)), survival time recode as calculated by the date of initial diagnosis and the date of death or the follow-up cutoff date, year of initial diagnosis, age of initial diagnosis, vital status, and cancer histologic type as coded by the ICD-O-3. Covariates such as age at initial diagnosis and year of initial diagnosis could affect the survival of breast cancer patients. I don’t usually discuss the personal aspects of my life with the whole world wide web, but this is just too important, so listen up.
In early 2007, my mom was diagnosed with primary peritoneal carcinoma, a cancer mostly commonly classified in the same category as ovarian cancer due to the similar prognosis and treatment.
Few people know much about ovarian cancer, but it’s important to be aware of the basics. This entry was posted in Viewpoints and tagged Break the Silence, cancer awareness, health, Laura Mercier, NOCC, ovarian cancer, teal on September 12, 2012 by jenn. I also took the BRCA test, and while I was relieved to be negative, it’s still in many ways a crap shoot. I also lost my other sister to melanoma, so am very familiar with cancer treatments and the horrible things it does to a person. About BeautypendenceWe hold these truths to be self-evident, that all women are created beautiful, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the Pursuit of Looking Your Best.
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Stage III of Ovarian cancer is a condition when the growth has spread from one or both ovaries to the coating of the belly or to the area of lymph hubs.
At Cancer Treatment Centers of America® (CTCA), we believe you have the right to know our statistics for ovarian cancer treatment outcomes, so you can choose the best cancer care for you and your family.
At Cancer Treatment Centers of America (CTCA), we believe that knowing the survival rates of ovarian cancer patients who are treated at our hospitals is one of the things that can help you and your family as you make this decision.
This means that six months after their diagnosis, nearly 92 percent of the patients in this group were still alive. Unfortunately, most hospitals and treatment centers don’t make their survival statistics available to the public.
This database is called the NCI Surveillance, Epidemiology and End Results Program, or SEER, for short. Because the SEER database did not provide staging information for patients diagnosed in 2004 and 2005, the SEER sample includes only those patients diagnosed between 2000 and 2003. Therefore, we asked an independent biostatistician to analyze the survival results of CTCA® patients. This means that six months after their diagnosis, 93% of the patients in this group were still living.
SEER is a source of population-based information about cancer incidence and survival in the United States that includes the stage of cancer at the time of diagnosis and patient survival data. Our fifth hospital, located near Atlanta, Georgia, was not included because it was not open to patients until August 2012. The independent biostatistician computed the survival outcomes of metastatic ovarian cancer patients from the CTCA database and metastatic ovarian cancer patients from the SEER database who were diagnosed between 2000 and 2011. These factors significantly reduced the size of the CTCA sample, which means that the estimates reflected in the survival chart may be subject to high variation and may not be replicated in the future when we have a larger CTCA sample for analysis.
Not all cancer patients who are treated at a CTCA hospital may experience these same results. More specifically, the SEER Limited-Use Database contained a combination of three databases. The survival outcome from the SEER database was provided by the SEER Limited-Use Data File as the number of completed years and the number of completed months. Formal statistical analyses of the ovarian cancer survival distributions between the CTCA database and the SEER database were conducted by the nonparametric logrank test and Wilcoxon test as well as the likelihood ratio test [1]. Similar estimates were also computed to estimate the difference of the survival rates at these time points between the two cohorts.
Therefore, additional adjusted analyses were completed on the survival outcomes between the CTCA and SEER samples after adjusting for the effects of these covariates. First, although a large cancer sample was available from the SEER program across many geographic regions in the United States, both samples, including the sample from CTCA, are convenience samples. There are several subtypes of ovarian cancer, and identifying those types requires careful evaluation by highly specialized pathologists. The Pathology Division houses the largest team of gynecology specialists in the world; this team discovered that many early cancers develop in the fallopian tubes, not just the ovaries. The results from these tests are reviewed regularly by a dedicated gynecology team of surgeons, medical oncologists, and radiation oncologists.
Diagnosis of ovarian cancer begins with a pelvic exam with your doctor, which can be helpful in identifying a mass on either side of the uterus.
This test is more often used to monitor the progress of treatment than as a screening test, since non-cancer problems can cause it to be elevated. There are genetic tests that can detect these mutated genes, for family members with a high risk of ovarian cancer.
Learning whether or not you carry a genetic mutation may influence how, how often, and when you and your family begin cancer screenings. The process used to find out if and how far the cancer has spread beyond the uterus is called staging. In some cases, the cancer can be removed at the time of surgery, along with affected organs, or to prevent cancer in organs later on.
The staging of ovarian cancer is the most important factor in determining a treatment plan.
Cancer cells may be found on the surface of the ovaries, inside the ovaries, or in fluid or tissue surrounding the abdomen. Cancer cells can be found in the fallopian tubes, uterus, or other tissues in the pelvis, as well as the tissue or fluid surrounding the abdomen. At Cancer Treatment Centers of America® (CTCA), we believe you have the right to know our statistics for breast cancer treatment outcomes, so you can choose the best cancer care for you and your family.


This means that six months after their diagnosis, 95% of the patients in this group were still living.
Therefore, we asked an independent biostatistician to analyze both the survival rates of CTCA patients and those of patients included in the SEER database.
Therefore, SEER is currently the most comprehensive database for the analysis of CTCA results and national results. Across all the 11 cancer types whose survival results are presented on the CTCA website, 0.48% of the CTCA patients included in the analyses were only diagnosed by CTCA and received no initial course of treatment from CTCA. In both cases, the patients had been diagnosed with metastatic or distant cancer – cancer that had traveled from the primary site (breast) to one or more distant sites in the body where it continued to grow. The independent biostatistician computed the survival outcomes of metastatic breast cancer patients from the CTCA database and metastatic breast cancer patients from the SEER database who were diagnosed between 2000 and 2011.
Fairly soon after her diagnosis, she had a tumor removed from her peritoneum (a membrane that forms the lining of the abdominal cavity) the size of a grapefruit and immediately began first line chemotherapy.
The symptoms are not specific (my mom had been feeling bloated for a while) and unlike breast cancer or cervical cancer, there are no early detection tests. Make a donation to the National Ovarian Cancer Coalition, whose mission is “to raise awareness and promote education about ovarian cancer. Laura Mercier has launched a special Ovarian Cancer Fund and have created two special products for the cause, a blush palette and lip gloss.
Knowledge is definitely power when it comes to something like this where there’s no cure yet.
I also lost my brother to liver cancer in 1999, so I 100% agree with everything you’ve said. Therefore, we asked an independent, third-party biostatistician to analyze the ovarian cancer survival rates of patients who were treated at CTCA. When they do, the results are not always consistently presented, so objective comparisons are difficult. This, among other factors, means that the estimates reflected in the survival chart may not be replicated in the future when a larger CTCA sample is available for comparison. SEER collects information on cancer incidence, prevalence and survival from specific geographic areas that represent 28% of the population of the United States. In both cases, the patients had been diagnosed with distant (metastatic) cancer as discussed above. The SEER Program is a comprehensive source of population-based information in the United States that includes stage of cancer at the time of diagnosis and patient survival data. Patients whose age at initial diagnosis fell into the overlap of the two ranges from the CTCA and SEER samples were included in the survival analysis. These were then converted to the number of years by dividing the number of total months by 12. Because the estimated survival curves might not estimate the survival probability at these specific time points, survival rates from the closest observed survival times were used. The nature of these convenience samples prevents a causal interpretation of the statistical inferences. Making the correct diagnosis is key to tailoring treatment to your specific type of cancer. With this knowledge, they are guiding research teams nationally on how ovarian tumors develop and how they can be prevented. This type of ovarian cancer is divided into serous (high grade and low grade), mucinous, endometrioid (high grade and low grade), clear cell, transitional, and undifferentiated types. This team will determine the best course of treatment specific to your type of ovarian cancer. Sometimes a Pap test — a procedure to collect cells from the surface of the cervix and vagina — may also be collected. In some cases, removing the fallopian tubes and ovaries will significantly reduce the risk of eventually developing ovarian or fallopian tube cancer.
In both cases, the patients had been diagnosed with distant (metastatic) cancer, as discussed above. After being dismissed as simply being obese, my mom went through a few doctors before she was diagnosed correctly. This means the cancer that had traveled from the primary site (ovary) to one or more distant sites in the body where it continued to grow. For these patients who were still alive or lost to follow-up at the time of entering the databases, their survival time was treated as statistically censored[1] at the difference between the date of last contact and the date of initial diagnosis. Because five-year survival rates have been popularly used in many cancer survival reports, five-year survival curves were also obtained by treating those who survived more than five years after the initial diagnosis as statistically censored at five years. Second, although some types of matching, as described above, were implemented to select the appropriate SEER and CTCA comparison samples, the distributions of important covariates such as age at initial diagnosis, race and year of initial diagnosis were not exactly the same between the CTCA sample and SEER sample. In these cases, the tubes and ovaries are carefully examined by pathologists who are experts in detecting early cancers.
It is also possible that the SEER database may contain some of the CTCA cancer cases that were part of the analysis. This means that the cancer had traveled from the primary site (breast) to one or more distant sites in the body where it continued to grow.
So while the five-year survival rate of women who are diagnosed early with ovarian cancer is high at 90%, only 19% of all cases fit that bill. In stage III, on the other hand, since the cancer has spread, it causes major side effects which must be held fast to, by the patient and the specialist. Because patients surviving more than five years remained part of the risk sets in the estimation of survival rates at any time within five years of diagnosis, the truncated survival curves were identical to the first portion of the complete survival curves. Hence, even with the adjusted analyses, the possible confounding of these factors to the analyses and results cannot be ruled out. Six months later, she began to feel better, gained her strength back, and went back to work.
Another Cox proportional hazards model was also used to simultaneously adjust for the effects of both covariates (age at diagnosis and year of initial diagnosis) in the survival analysis. Ovarian cancer has the highest mortality rate of any cancer associated with the female reproductive system.
Third, the survival analyses were based on the statistical comparisons of the rate of death from all possible causes, not solely the cancer-specific death.
She went through several different second line chemotherapy drugs, but nothing seemed to help. The American Cancer Society estimates that more than 22,000 women in the United States will be diagnosed with ovarian cancer in 2012; more than 15,000 women will die from the disease. Data from CTCA are not available for a statistical comparison on cancer cause-specific death rates.



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