Secondary malignancies in long-term ovarian cancer survivors: results of the ‘Carolin meets HANNA’ study

2021 ◽  
pp. ijgc-2020-002155
Author(s):  
Hannah Woopen ◽  
Carolin Rolf ◽  
Elena Ioana Braicu ◽  
Nina Buttmann-Schweiger ◽  
Benjamin Barnes ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Cancer Survival ◽  
Secondary Malignancy ◽  
Secondary Cancer ◽  
Secondary Malignancies ◽  
Primary Ovarian Cancer ◽  
Long Term Survivors

ObjectiveTo evaluate the rate of secondary malignancies in long-term survivors with ovarian cancer.MethodsLong-term survivors with ovarian cancer (survival ≥8 years after initial diagnosis) with multiple malignancies were identified within the Tumorbank Ovarian Cancer and our study ‘Carolin meets HANNA – Holistic Analyses of Long-term Survivors with Ovarian Cancer’.ResultsOf a total of 225 long-term survivors with ovarian cancer, 36 patients (16%) had at least one more cancer diagnosis before, concomitant with, or after, ovarian cancer. Median age was 52.5 years (range 37–79). A total of 60% were diagnosed with stage III/IV and most tumors were high-grade (88.6%), as well as of serous histology (63.9%). Median overall survival was 10 years (range 8–19). Secondary cancer after ovarian cancer was found in 17 long-term survivors (7.6%). Breast cancer was the most frequent secondary malignancy. Median duration between diagnosis of primary ovarian cancer and secondary cancer diagnosis was 78.5 months (range 12–220). BRCA was tested in 11 patients with seven patients being BRCA1 and one patient BRCA2 positive. Secondary cancers were detected by screening in 35.3% and self-detected in 29.4% of patients (breast self-examination).ConclusionA secondary malignancy was diagnosed in 7.6% of long-term survivors. Routine follow-up and cancer screening should be performed in long-term ovarian cancer survivors.

Genitourinary disease risks among 5-year ovarian cancer survivors in a population-based cohort study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10073-10073
Author(s):  
Mia Hashibe ◽  
Yuji Chen ◽  
Brenna Blackburn ◽  
Yuan Wan ◽  
Kerry G. Rowe ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Population Based ◽  
General Population Cohort ◽  
Disease Risks ◽  
After Cancer

10073 Background: In the US, there are approximately 235,200 ovarian cancer survivors today. Five-year survival for ovarian cancer has increased from 36% for women who were diagnosed in 1975-1977 to 46% for women diagnosed between 2005-2011. Long term follow-up studies among ovarian cancer survivors are uncommon and late effects have not been well characterized in a population-based cohort. Although genitourinary complications during treatment are well known, long term impacts need to be investigated. Methods: A total of 602 first primary invasive ovarian cancer cases diagnosed between 1996-2012 who survived for > 5 years were identified in the Utah Population Database and compared to a general population cohort of women. Genitourinary disease diagnoses were identified through ICD codes from hospital electronic medical records and statewide ambulatory surgery and inpatient data. Cox regression models were used to estimate hazard ratios for disease risks by time since cancer diagnosis with adjustments on matching factors, baseline BMI, baseline Charlson Comorbidity Index (CCI), and race. Results: The overall risk of genitourinary diseases for ovarian cancer patients in comparison to the general population cohort was 1.51 (95%CI = 1.30-1.74) 5-10 years after cancer diagnosis. Approximately 54.6% of ovarian cancer survivors were diagnosed with a genitourinary disease 5-10 years after cancer diagnosis. The most common genitourinary diseases among the ovarian cancer survivors were urinary tract infections (10.1%), acute renal failure (5.5%), and chronic kidney disease (4.4%). The greatest risks were observed for hydronephrosis (HR = 10.65, 95%CI = 3.68-30.80), pelvic peritoneal adhesions (HR = 5.81, 95%CI = 1.11-30.39), cystitis and urethritis (HR = 2.67, 95%CI = 1.21-6.38), and acute renal failure (HR = 2.30, 95%CI = 1.36-3.88). Conclusions: Ovarian cancer survivors experience increased risks of various genitourinary diseases in the 5-10 year period following cancer diagnosis. Understanding the multimorbidity trajectory among ovarian cancer survivors is of vital importance to improve their clinical care after cancer diagnosis and allow for increased attention to these potential late effects.

Causes of death among women with epithelial ovarian cancer by length of survival post-diagnosis: a population-based study in British Columbia, Canada

2018 ◽  
Vol 29 (3) ◽  
pp. 593-598 ◽  
Author(s):  
Nimisha Arora ◽  
Aline Talhouk ◽  
Jessica N. McAlpine ◽  
Michael R. Law ◽  
Gillian E. Hanley
Keyword(s):  
Colorectal Cancer ◽  
Ovarian Cancer ◽  
British Columbia ◽  
Cancer Survivors ◽  
Epithelial Ovarian Cancer ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Causes Of Death ◽  
Population Based

ObjectivesLittle is known regarding the health of women who survive more than 5 years following their ovarian cancer diagnosis. To bridge an important gap in our knowledge about long term health of ovarian cancer survivors, we examined the causes of death among women diagnosed with epithelial ovarian cancer between 1990 and 2014 in British Columbia. These causes were stratified by years since diagnosis, and compared with age- standardized causes of death among women who have not been diagnosed with ovarian cancer.MethodsWe examined all women with epithelial ovarian cancer in British Columbia 1990–2014 using population- based administrative datasets. We stratified women into three groups: all epithelial ovarian cancer patients; women surviving 5 to 9 years post-diagnosis, and women surviving 10 or more years since diagnosis. All- cause and cause specific standardized mortality ratios (SMRs) were calculated.ResultsThere were 4246 deaths among 6427 women with epithelial ovarian cancer. About 55.9% of deaths were from ovarian cancer. When compared with the general population, the highest SMRs (SMR of 5 or higher) were for deaths from other cancers and external causes (44.4% from falls) among women surviving 5–9 years and 10 or more years post-diagnosis. Mortality from other cancers can largely be explained by deaths from breast cancer (15.8%), lung cancer (12.3%), and colorectal cancer (11%).ConclusionsWhile the majority of epithelial ovarian cancer patients continue to die from their ovarian cancer, our results suggest that long term ovarian cancer survivors are particularly vulnerable to deaths from other cancers and from falls in elderly survivors. These data could indicate closer surveillance for breast, lung, and colorectal cancer, and closer attention to bone health is warranted among women surviving for 5 or more years following their epithelial ovarian cancer diagnosis.

scholarly journals Attributions of survival and methods of coping of long-term ovarian cancer survivors: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dana Ketcher ◽  
Susan K. Lutgendorf ◽  
Susan Leighton ◽  
Marianne Matzo ◽  
Jeanne Carter ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Survivors ◽  
Coping Strategies ◽  
Cancer Patients ◽  
Qualitative Interviews ◽  
Personal Characteristics ◽  
Term Survival ◽  
Targeted Interventions ◽  
Long Term Survivors

Abstract Background Only 8–23% of advanced epithelial ovarian cancer patients survive for 10 years or longer. Given the need for targeted interventions to improve survival, we interviewed this relatively rare survivor population to gain personalized insights into the reasons for their survival. The aim of this study was to characterize subjective attributions of survival and specific coping mechanisms long-term survivors of ovarian cancer. Methods Twenty-two semi-structured, qualitative interviews assessing survival attributions and coping strategies were conducted from April to November 2014. Data were analyzed in a multistep process using ATLAS.ti.8: codes were identified during review of the transcripts and refined with literature review; the frequency of codes and code co-occurrence was calculated, and codes were grouped into themes. Resulting themes were checked by a national leader of an ovarian cancer advocacy organization and compared against available literature. Results Thematic analysis found that participants credited their long-term survival to a variety of factors including medical, social, religious/spiritual, and lifestyle/personal characteristics. Some participants rejected these same attributions, concluding that the reason for survival was due to luck or unknowable. Several of Carver et al.’s theoretical dimensions of coping were evident in our sample: planning, positive reinterpretation, social support, religion and acceptance whereas three relatively new strategies were uncovered: conserving emotional energy, value-based activity coping, and self-care. Conclusions Long-term survivors’ perspectives were largely consistent with those of newly diagnosed ovarian cancer patients and ovarian cancer survivors of shorter duration. However, the long-term survivors were also willing to reject conventional attributions for survival and recognized the importance of disciplined self-preservational coping strategies.

scholarly journals Physical Comorbidities and Depression in Recent and Long-Term Adult Cancer Survivors: NHANES 2007–2018

Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3368
Author(s):  
Dafina Petrova ◽  
Andrés Catena ◽  
Miguel Rodríguez-Barranco ◽  
Daniel Redondo-Sánchez ◽  
Eloísa Bayo-Lozano ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Depression Symptoms ◽  
Depression Risk ◽  
Adult Cancer Survivors ◽  
Before And After ◽  
Nationally Representative ◽  
Risk Of Cancer

Many adult cancer patients present one or more physical comorbidities. Besides interfering with treatment and prognosis, physical comorbidities could also increase the already heightened psychological risk of cancer patients. To test this possibility, we investigated the relationship between physical comorbidities with depression symptoms in a sample of 2073 adult cancer survivors drawn from the nationally representative National Health and Nutrition Examination Survey (NHANES) (2007–2018) in the U.S. Based on information regarding 16 chronic conditions, the number of comorbidities diagnosed before and after the cancer diagnosis was calculated. The number of comorbidities present at the moment of cancer diagnosis was significantly related to depression risk in recent but not in long-term survivors. Recent survivors who suffered multimorbidity had 3.48 (95% CI 1.26–9.55) times the odds of reporting significant depressive symptoms up to 5 years after the cancer diagnosis. The effect of comorbidities was strongest among survivors of breast cancer. The comorbidities with strongest influence on depression risk were stroke, kidney disease, hypertension, obesity, asthma, and arthritis. Information about comorbidities is usually readily available and could be useful in streamlining depression screening or targeting prevention efforts in cancer patients and survivors. A multidimensional model of the interaction between cancer and other physical comorbidities on mental health is proposed.

Abstract # 1740 Stress and depression levels predict neuroendocrine dynamics in long term ovarian cancer survivors

2016 ◽  
Vol 57 ◽  
pp. e10
Author(s):  
S.K. Lutgendorf ◽  
M.G. Cuneo ◽  
A. Schrepf ◽  
P.H. Thaker ◽  
M. Goodheart ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Survivors

scholarly journals Quality of life among long-term survivors of advanced stage ovarian cancer: A cross-sectional approach

2017 ◽  
Vol 146 (1) ◽  
pp. 101-108 ◽  
Author(s):  
Susan K. Lutgendorf ◽  
Eileen Shinn ◽  
Jeanne Carter ◽  
Susan Leighton ◽  
Keith Baggerly ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ovarian Cancer ◽  
Advanced Stage ◽  
Cross Sectional ◽  
Long Term Survivors

Salvage radiation therapy for localized recurrent ovarian cancer

2019 ◽  
Vol 29 (5) ◽  
pp. 916-921
Author(s):  
Alicia Smart ◽  
Yu-Hui Chen ◽  
Teresa Cheng ◽  
Martin King ◽  
Larissa Lee
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Clear Cell ◽  
Recurrent Ovarian Cancer ◽  
Salvage Radiotherapy ◽  
Platinum Sensitive ◽  
Long Term Survivors ◽  
Disease Free

IntroductionTo evaluate clinical outcomes for patients with localized recurrent ovarian cancer treated with salvage radiotherapy.MethodsIn a retrospective single institutional analysis, we identified 40 patients who received salvage radiotherapy for localized ovarian cancer recurrence from January 1995 to June 2011. Recurrent disease was categorized as: pelvic peritoneal (45%, 18), extraperitoneal/nodal (35%, 14), or vaginal (20%, eight). Actuarial disease-free and overall survival estimates were calculated by Kaplan–Meier and prognostic factors evaluated by the Cox proportional hazards model.ResultsMedian follow-up was 42 months. Median patient age was 54 years (range, 27–78). Histologic subtypes were: serous (58%, 23), endometrioid (15%, six), clear cell (13%, five), mucinous (8%, three), and other (8%, three). At the time of salvage radiotherapy, surgical cytoreduction was performed in 60% (24) and 68% (27) had platinum-sensitive disease. Most patients (63%, 25) received salvage radiotherapy at the time of first recurrence. Relapse after salvage radiotherapy occurred in 29 patients at a median time of 16 months and was outside the radiotherapy field in 62%. 18 At 3 years, disease-free and overall survival rates were 18% and 80%, respectively. On multivariate analysis, non-serous histology (hazards ratio 0.3, 95% CI 0.1–0.7) and platinum-sensitivity (hazards ratio 0.2, 95% CI 0.1–0.5) were associated with lower relapse risk. Platinum-sensitivity was also associated with overall survival (hazards ratio 0.4, 95% CI 0.1–1.0). Four patients (10%) were long-term survivors without recurrence 5 years after salvage radiotherapy. Of the five patients with clear cell histology, none experienced relapse at the time of last follow-up.DiscussionPatients with non-serous and/or platinum-sensitive ovarian cancer had the greatest benefit from salvage radiotherapy for localized recurrent disease. Although relapse was common, radiotherapy prolonged recurrence for > 1 year in most patients and four were long-term survivors.

scholarly journals A Retrospective Evaluation of Risk of Peripartum Cardiac Dysfunction in Survivors of Childhood, Adolescent and Young Adult Malignancies

Cancers ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1046
Author(s):  
Chait-Rubinek ◽  
Mariani ◽  
Goroncy ◽  
Herschtal ◽  
Wheeler ◽  
...  
Keyword(s):  
At Risk ◽  
Young Adult ◽  
Cancer Diagnosis ◽  
Cardiac Dysfunction ◽  
Adolescent And Young Adult ◽  
Cardiac Events ◽  
Increased Risk ◽  
Cardiac Assessment ◽  
Long Term Survivors

Long-term survivors of childhood, adolescent and young adult (AYA) malignancies with past exposure to potentially cardiotoxic treatments are at risk of peripartum cardiac dysfunction. Incidence and risk factors for peripartum cardiac dysfunction and maternal cardiac outcomes in this population were investigated. Eligible long-term survivors were aged <30 years at cancer diagnosis, with ≥1 pregnancy occurring ≥5 years after diagnosis. “Peripartum” cardiac events were defined as occurring within pregnancy or ≤5months after delivery. Cardiac events were classified “symptomatic” or “subclinical”. “Peripartum cardiomyopathy” (PPCM) was defined as symptomatic dysfunction without prior cardiac dysfunction. Of 64 eligible women, 5 (7.8%) had peripartum cardiac events: 3 symptomatic, 2 subclinical. Of 110 live births, 2 (1.8%, 95% CI 0.2–6.4) were defined as PPCM: Significantly greater than the published general population incidence of 1:3000 (p < 0.001), representing a 55-fold (95% CI 6.6–192.0) increased risk. Risk factor analyses were hypothesis-generating, revealing younger age at cancer diagnosis and higher anthracycline dose. Postpartum, cardiac function of 4 women (80%) failed to return to baseline. In conclusion, peripartum cardiac dysfunction is an uncommon but potentially serious complication in long-term survivors of paediatric and AYA malignancies previously treated with cardiotoxic therapies. Peripartum cardiac assessment is strongly recommended for at-risk patients.

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