- Wenzel, Lari;
- Osann, Kathryn;
- McKinney, Chelsea;
- Cella, David;
- Fulci, Giulia;
- Scroggins, Mary J;
- Lankes, Heather A;
- Wang, Victoria;
- Nephew, Kenneth P;
- Maxwell, George L;
- Mok, Samuel C;
- Conrads, Thomas P;
- Miller, Austin;
- Mannel, Robert S;
- Gray, Heidi J;
- Hanjani, Parviz;
- Huh, Warner K;
- Spirtos, Nick;
- Leitao, Mario M;
- Glaser, Gretchen;
- Sharma, Sudarshan K;
- Santin, Alessandro D;
- Sperduto, Paul;
- Lele, Shashikant B;
- Burger, Robert A;
- Monk, Bradley J;
- Birrer, Michael
Background
There is a critical need to identify patient characteristics associated with long-term ovarian cancer survival.Methods
Quality of life (QOL), measured by the Functional Assessment of Cancer Therapy-Ovarian-Trial Outcome Index (FACT-O-TOI), including physical, functional, and ovarian-specific subscales, was compared between long-term survivors (LTS) (8+ years) and short-term survivors (STS) (<5 years) of GOG 218 at baseline; before cycles 4, 7, 13, 21; and 6 months post-treatment using linear and longitudinal mixed models adjusted for covariates. Adverse events (AEs) were compared between survivor groups at each assessment using generalized linear models. All P values are 2-sided.Results
QOL differed statistically significantly between STS (N = 1115) and LTS (N = 260) (P < .001). Baseline FACT-O-TOI and FACT-O-TOI change were independently associated with long-term survival (odds ratio = 1.05, 95% confidence interval = 1.03 to 1.06 and odds ratio = 1.06, 95% confidence interval = 1.05 to 1.07, respectively). A 7-point increase in baseline QOL was associated with a 38.0% increase in probability of LTS, and a 9-point increase in QOL change was associated with a 67.0% increase in odds for LTS. QOL decreased statistically significantly with increasing AE quartiles (cycle 4 quartiles: 0-5 vs 6-8 vs 9-11 vs ≥12 AEs, P = .01; cycle 21 quartiles: 0-2 vs 3 vs 4-5 vs ≥6 AEs, P = .001). Further, LTS reported statistically significantly better QOL compared with STS (P = .03 and P = .01, cycles 4 and 21, respectively), with similar findings across higher AE grades.Conclusions
Baseline and longitudinal QOL change scores distinguished LTS vs STS and are robust prognosticators for long-term survival. Results have trial design and supportive care implications, providing meaningful prognostic value in this understudied population.