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Ovarian cancer survival by tumor dominance, a surrogate for site of origin

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Abstract

Objectives

Recent studies suggest that a proportion of ovarian tumors may actually originate in the distal fallopian tube. The objective of this study was to examine the relationship between dominance (a surrogate for site of origin) and survival, following a diagnosis of epithelial ovarian cancer.

Methods

We classified 1,386 tumors as dominant (putatively originating in the ovary) and non-dominant (putatively originating in the fallopian tube), using parameters obtained from pathology reports. Dominant tumors were restricted to one ovary or one involved ovary that exceeded the other in dimension by at least twofold, while non-dominant tumors were identified as having a greater likelihood of a tubal origin if the disease was equally distributed across the ovaries. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95 % confidence intervals (CIs) associated with dominance.

Results

Non-dominant tumors were more likely to be serous, stage III/IV, and be associated with a BRCA1/2 mutation, increasing parity and use of estrogen hormone replacement therapy (p ≤ 0.01). In contrast, 46 and 26 % of the dominant tumors were serous and endometrioid, respectively, with a more even distribution of stage (p < 0.0001). Women with a non-dominant tumor had an increased risk of death compared to women with a dominant tumor (multivariate HR 1.28; 95 % CI 1.02–1.60). Findings were similar in our analysis restricted to serous only subtypes (HR 1.28; 95 % CI 1.01–1.63).

Conclusion

These preliminary findings suggest significantly worse survival among women diagnosed with a tumor putatively arising from fallopian tube.

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Acknowledgments

Joanne Kotsopoulos is the recipient of a Cancer Care Ontario Research Chair in Population Studies and a Canadian Cancer Society Career Development Award in Prevention. Steven Narod is the recipient of a Canada Research Chair tier I. This study was supported by a Cancer Care Ontario—Population Sciences Research Network grant. The study was also supported by US National Institutes of Health grants R01-CA063678 (Narod) and R01-CA063682 (Risch).

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Authors and Affiliations

  1. Women’s College Research Institute, Women’s College Hospital, 790 Bay Street, 7th Floor, Toronto, ON, M5G 1N8, Canada

    Anna Ivanova, Anneli Loo, Steven A. Narod & Joanne Kotsopoulos

  2. Dalla Lana School of Public Health, University of Toronto, 155 College Street, Health Science Building, 6th Floor, Toronto, ON, Canada

    Anna Ivanova, Steven A. Narod & Joanne Kotsopoulos

  3. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

    Shelley Tworoger

  4. Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Shelley Tworoger

  5. Division of Women’s and Perinatal Pathology, Department of Pathology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Christopher P. Crum

  6. Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Joseph and Wolf Lebovic Health Complex, 600 University Avenue, Toronto, ON, Canada

    Isabel Fan & John R. McLaughlin

  7. Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON, Canada

    Barry Rosen

  8. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Toronto, Main Floor Room 719, 610 University Ave, Toronto, ON, Canada

    Barry Rosen

  9. Department of Chronic Disease Epidemiology, Yale School of Public Health, 60 College St., New Haven, CT, USA

    Harvey Risch

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  1. Anna Ivanova
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  2. Anneli Loo
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  3. Shelley Tworoger
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  5. Isabel Fan
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  8. Harvey Risch
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  9. Steven A. Narod
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  10. Joanne Kotsopoulos
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Correspondence to Joanne Kotsopoulos.

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Ivanova, A., Loo, A., Tworoger, S. et al. Ovarian cancer survival by tumor dominance, a surrogate for site of origin. Cancer Causes Control 26, 601–608 (2015). https://doi.org/10.1007/s10552-015-0547-y

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  • DOI: https://doi.org/10.1007/s10552-015-0547-y

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