How long have we got? The accuracy of physicians’ estimates and scenarios for survival time in 898 women with recurrent ovarian cancer (ROC).

Authors

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Felicia Roncolato

Macarthur Cancer Therapy Centre, Sydney, Australia

Felicia Roncolato , Rachel O'Connell , Florence Joly , Anne Lanceley , Felix Hilpert , Aikou Okamoto , Eriko Aotani , Sandro Pignata , Paul P. Donnellan , Amit M. Oza , Elisabeth Avall-Lundqvist , Jonathan S. Berek , Jalid Sehouli , Jonathan A. Ledermann , Dominique Berton-Rigaud , Belinda Emma Kiely , Michael Friedlander , Martin R. Stockler

Organizations

Macarthur Cancer Therapy Centre, Sydney, Australia, NHMRC Clinical Trials Centre, The University of Sydney, Sydney, Australia, GINECO and Regional Centre Control Against Cancer Francois Baclesse, Caen, France, University College London Hospitals, London, United Kingdom, UKSH Campus Kiel, Kiel, Germany, The Jikei University School of Medicine, Tokyo, Japan, Kanagawa Academy of Science and Technology, Kawasaki, Japan, National Cancer Institute of Naples, Naples, Italy, Galway University Hospital, Galway, Ireland, Princess Margaret Cancer Centre, Toronto, ON, Canada, Linköping University and Karolinska Institute, Linköping, Sweden, Stanford Women's Cancer Center, Stanford, CA, AGO and Charité Campus Virchow-Klinikum, Berlin, Germany, University College London Cancer Institute, London, United Kingdom, ICO Centre Rene Gauducheau, Saint-Herblain, France, Department of Medical Oncology, Prince of Wales Hospital, Sydney, New South Wales, Australia

Research Funding

Other
Target Ovarian Cancer and the Cancer Research U.K. and UCL Cancer Trials Centre (Programme Grant C444/A15953)

Background: Predicting, formulating, and communicating prognosis in women with ROC is difficult. Best-case, worst-case, and typical scenarios for survival time based on simple multiples of an individual’s expected survival time (EST) estimated by their oncologist have proven accurate and useful in a range of advanced cancers. We sought the accuracy and prognostic significance of such estimates in the GCIG Symptom Benefit Study: a multinational, prospective cohort study of women with ROC (platinum resistant and potentially platinum sensitive ROC who have had more than 2 lines of chemotherapy). Methods: Oncologists estimated EST at baseline for each woman they recruited to the GCIG Symptom Benefit Study in 11 countries. We hypothesised a priori that oncologists’ estimates of EST would be unbiased (equal proportions [approximately 50%] of women living longer versus shorter than their EST), imprecise ( < 33% living within 0.75 to 1.33 times their EST), and provide accurate scenarios for survival time (approximately 10% dying within ¼ of their EST, 10% living longer than 3 times their EST, and 50% living from half to double their EST). We also hypothesised that oncologists’ estimates of EST would be independently significant predictors of survival in a multivariable Cox model adjusting for prognostic factors established in previous studies. Results: Oncologists’ individualised estimates of EST in 898 women with ROC were unbiased (55% of women lived longer than their EST) and imprecise (23% lived within 0.75 to 1.33 times their EST). Scenarios for survival time based on oncologists’ estimates of EST were remarkably accurate: 7% of women died within ¼ of their EST, 13% lived longer than 3 times their EST, and 53% lived from half to double their EST. The median EST was 12 months (range 3-70), and median observed was 12.7 months. Oncologists’ estimates of EST were independently significant predictors of overall survival (HR 0.96, CI 0.94-0.98, p < 0.0001) in Cox models accounting for previously established prognostic factors. Conclusions: Oncologists’ estimates of EST were unbiased, imprecise, and independently significant predictors of survival time. Best-case, worst-case and typical scenarios based on simple multiples of EST were remarkably accurate, and provide a useful approach for predicting, formulating, and explaining prognosis in women with recurrent ovarian cancer. Clinical trial information: ACTRN: 12607000603415.

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Abstract Details

Meeting

2019 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Gynecologic Cancer

Track

Gynecologic Cancer

Sub Track

Ovarian Cancer

Clinical Trial Registration Number

ACTRN: 12607000603415

Citation

J Clin Oncol 37, 2019 (suppl; abstr 5549)

DOI

10.1200/JCO.2019.37.15_suppl.5549

Abstract #

5549

Poster Bd #

372

Abstract Disclosures