Clinical characteristics and prognostic inflection points among long‐term survivors of advanced epithelial ovarian cancer

Objective To assess clinical characteristics of long‐term survivors of advanced epithelial ovarian cancer (EOC) to define a prognostic inflection point for long‐term survival. Methods A retrospective analysis was undertaken of patients with FIGO stage III or IV EOC treated at one center in South Korea from 2000 to 2012. Patients who survived 5 years or more were identified, and the periods of disease‐free survival and overall survival were evaluated for prognostic inflection points to indicate long‐term survival. Clinicopathologic data and treatment‐associated factors were assessed. Results In total, 60 patients survived more than 5 years. Thirty‐three (55%) patients experienced disease recurrence and 11 (18%) died due to advanced EOC during a median follow‐up period of 92 months (range 61–205). Most recurrence events (32/33, 97%) and deaths (10/11, 91%) occurred within 6 years and 8 years, respectively. Although half the long‐term (>8 year) survivors with stage IIIC–IV disease experienced disease recurrence, they had a significantly longer platinum‐free interval (P=0.007) and tended to have received aggressive surgical treatments after disease recurrence (P=0.054), as compared with survivors for 5–8 years. Conclusion Survival for 8 years might represent a prognostic inflection point for long‐term survival in advanced EOC. Long‐term mortality in advanced ovarian cancer decreased substantially among survivors of more than 8 years. Eight‐year overall survival might represent a prognostic inflection point.