Ovarian cancer prognosis

Among the causes of death from oncological diseases that occur in women in Europe, malignant ovarian tumors have reached sixth place. However, as experts from ESMO (European Society for Medical Oncology) note, despite the emergence of new drugs and improvements in treatment methods, the prognosis for ovarian cancer remains unfavorable, and the average five-year survival rate for ovarian cancer is 70% for non-epithelial forms of cancer and 25-35% for epithelial forms (but this does not take into account the specific stage of the disease).

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Prognosis for stage 1 ovarian cancer

In oncology, determining the stage of cancer is a mandatory diagnostic condition, allowing doctors to choose a treatment plan that corresponds to a particular stage of the tumor process and its biological characteristics, including the cytological structure of neoplasms.

In many ways, the prognosis for ovarian cancer depends on the stage of tumor development, i.e. its initial (at the time of detection) size, localization, spread to the lymph nodes and other organs and parts of the body. In addition, the degree of differentiation of the tumor cells and the rate of their reproduction, the age and general condition of the patients and, of course, the body's response to the treatment are taken into account.

The prognosis for ovarian cancer at stage 1 is considered the most favorable, since this is an early stage and the cancer has not yet spread beyond the ovaries. Although this only applies to stages 1A (only one ovary is affected) and 1B (both ovaries are affected), and already at stage 1C, cancer cells can be detected outside the ovary.

If the tumor is detected at this stage, then the five-year survival rate for ovarian cancer, according to the American Cancer Society (ACS), is 92% (at stage 1C - no more than 80%). But this does not mean that new patients will live only five years 5 years. This statistical indicator accepted in medicine records the number of people who are alive 5 years after diagnosis and treatment. Five years is not the maximum life span, it is just that the probability of cancer recurrence after such a period of time is considered low.

But cancer can be different: invasive epithelial, stromal and germinogenic. In 8-9 cases out of 10, epithelial cancer is diagnosed (oncologists call it carcinoma), and it affects the epithelial cells of the outer shell of the ovaries. With this histological type of tumor, the prognosis for stage 1 ovarian cancer relative to five-year life expectancy ranges from 55 to 80%.

If the ovarian stromal cells that produce sex hormones are affected, histology determines stromal neoplasia. The prognosis for this type of cancer at an early stage is 95% five-year survival.

In the case of germ cell ovarian cancer (when the cells of the ovarian cortex, where the follicles with eggs are concentrated, mutate and grow), the average survival rate of patients over the next five years is the highest - 96-98%. However, the matter is significantly complicated by the fact that only about 15% of ovarian cancer cases are diagnosed at the first stage.

Prognosis for ovarian cancer stage 2

In stage 2, cancer has migrated from one or both ovaries further to the fallopian tubes and uterus (stage 2A) or to the bladder and nearby parts of the colon (stage 2B).

Therefore, the prognosis for ovarian cancer at stage 2 – after removal of the uterus and chemotherapy – is much worse than at stage 1: in fact, this is the prognosis for ovarian cancer with metastases affecting many organs of the pelvis and abdominal cavity, and on average 44% of women continue to live for at least five years (according to the most recent data, 55-68%).

Experts note the importance of both complete removal of tumor tissue during surgery and the effectiveness of cytostatic drugs used in chemotherapy for prolonging life. Because these factors are decisive for stopping further growth of neoplasia. Obviously, these factors also explain the difference in survival rates for ovarian cancer cited by foreign gynecological oncologists (USA, Germany, Israel): in general - up to 70%; for invasive epithelial cancer - 55-75%; for stromal - 70-78%; for germ cell - 87-94%.

Prognosis for ovarian cancer stage 3

The unfavorable prognosis of ovarian cancer at stage 3 is primarily due to the fact that at this stage, malignant cells have already invaded the serous lining of the abdominal cavity (peritoneum) or spread to the retroperitoneal lymph nodes, as well as to other pelvic organs and lymph nodes within the abdominal cavity.

With the epithelial type of tumor, the prognosis for ovarian cancer at stage 3 (3A and 3B) is 25-40%; with stromal - up to 63%; with germ cell - less than 84%.

At stage 3C, cancer cell clusters can be found on the surface of the liver or spleen, or in nearby lymph nodes. In this case, excess fluid in the abdominal cavity - malignant ascites - promotes more active dissemination of tumor cells with lymph flow, and the prognosis for ovarian cancer with ascites is extremely unfavorable: in addition to liver damage, cancer cells also attack other internal organs, which leads to a decrease in survival to 10-15% over 3.5-5 years.

Prognosis for ovarian cancer stage 4

The prognosis of ovarian cancer with metastases at this stage of the disease is unfavorable in its outcome due to tumor metastasis to many organs: the presence of atypical cells in the pleural fluid and damage to lung tissue (at stage 4A); inside the liver, in distant lymph nodes, in the skin, in the bone or brain (at stage 4B).

As some experts note, the prognosis for stage 4 ovarian cancer in terms of five-year survival rate does not exceed 7-9%. Others claim that survival rate (after surgery and courses of cytostatic treatment) does not exceed 5%.

Some oncologists cite an even lower survival rate for malignant ovarian tumors at this stage: 1.5-2%, since the situation is aggravated by all sorts of complications that are inevitable during chemotherapy.

According to experts from the World Cancer Research Fund (WCRF), 75 out of 100 patients survive one year after ovarian cancer is diagnosed, but 15 times fewer survive five years if they seek medical help at the later stages of the disease.

Once again, it should be emphasized that the prognosis for ovarian cancer is an average statistical indicator based on the medical histories of a large number of patients. And whatever this prognosis is, it cannot accurately predict what will happen to you. Statistics cannot take into account all the features, and many individual factors influence the success of treatment and survival in ovarian cancer.