Long-Term Survival Among Histological Subtypes in Advanced Epithelial Ovarian Cancer: Population-Based Study Using the Surveillance, Epidemiology, and End Results Database https://tinyurl.com/8udkpevw            Information about the ultimate fate of long-term survivors after ovarian cancer is scarce. This retrospective study looks at a large number of women and matches their outcome to the type of ovarian cancer          Data for more than 8000 women with stage III/IV ovarian cancer was collected from the SEER database. All these women were diagnosed during the period 2000-2014 and had survived 5 years or more after initial diagnosis.          Despite their long-term survival, most of these women (80%) died from ovarian cancer, particularly the serous epithelial subtypes. For other subtypes it is less likely that women will die from ovarian cancer,...

Conditional Relative Survival of Ovarian Cancer: A Korean National Cancer Registry Study   https://tinyurl.com/8t4h8eht            It has been long thought that the chances of survival with ovarian cancer increase with time after initial diagnosis. This study, from Korea, provides an objective measure of how significant this improvement is.          Retrospective review of almost 300 thousand women with ovarian cancer, of whom about two thirds died, showed that the most dangerous period was the first year; when about 12% of patients die. All the women were diagnosed during the period 1997-2016 .          For each year after the first the odds of 5 years survival increase; from 61% initially to 84% after 5 years. Survival is longer in Korea than Australia due to the different mix of ovarian cancer, with endometrioid and clear cell cancer being m...

Physician Variation in End-of-Life Care Among Women With Ovarian Cancer https://tinyurl.com/2sydhrrz            Ovarian cancer patients who are terminal should have access to a dignified and controlled death. So, why is this rarely the case? Sometimes the patient is unwilling to accept the inevitable and wishes to continue active treatment. More often this is physician driven.          This retrospective study looked at Medicare benefits for more than 6,000 women during the period 2000-2016. These women were all aged more than 66; they had end-stage ovarian cancer.          More than half of these women had aggressive end-of life treatment, with failure to start Palliative Care, admission to an ICU, an invasive procedure and chemotherapy during the last two weeks of life being the commonest. Analysis of the data showed a cluster of inappropriate car...

Attributions of survival and methods of coping of long-term ovarian cancer survivors: a qualitative study https://tinyurl.com/4336wckr            Surviving ovarian cancer is the exception, not the rule.  Which means that those who do survive are worthy of study, looking for practical and emotional routines that may be helpful to others.          Ten-year survival is even more exceptional, with about 8% of Stage IV ovarian cancer patients living this long after diagnosis. This study looked at 22 women, trying to establish common strategies or tactics. Because of the scarcity of long-term survivors, the study is small and biased towards the white and wealthy.          Unsurprisingly there was no feature common to all the women. A small number (5 of the 22) thought they were just lucky, none felt guilty. For those who had faith, it usually st...

Homologous Recombination Deficiency Assays in Epithelial Ovarian Cancer: Current Status and Future Direction https://tinyurl.com/2pbwkmxm          Sometimes progress in the care of patients with ovarian cancer seems painfully slow. Then new understanding begins to show a way forward. One such innovation was the appreciation that much cancer starts due to a failure of repair in the DNA that makes up the cell nucleus. Cellular DNA is under constant attack from within and without. If DNA is not repaired cells will usually die but sometimes the cell line continues as a cancer.           Faulty DNA repair, known as Homologous Recombination Deficiency (HRD) is seen with  BRCA1/2 mutation  and sometimes with other acquired mutations, being present in about 50% of all ovarian cancer. As a consequence another enzyme; Polyadenosine Ribonucleotide Polymerase (PARP) becomes more important in DNA repair. Repair by PARP i...

Pre-implantation genetic testing for BRCA gene mutation carriers: a cost effectiveness analysis https://tinyurl.com/evhm49d2            For some communities ovarian cancer is a real and constant threat, none more so than for the Ashkenazi in Israel. Ovarian cancer is related to an inherited condition in about 25% of cases. The Ashkenazi have a high incidence of BRCA1/2 mutation, which increases the likelihood of developing ovarian cancer compared to the general population.          One strategy for avoiding ovarian cancer and the common fatal consequence is by prevention through pre-implantation genetic screening and selection of embryos, as part of In Vitro Fertilisation (IVF). This study seeks to determine the cost-effectiveness of doing this for parents who carry the BRCA1/2 gene.          Cost-effectiveness is routinely determined as a measure k...

Association Between Overall Survival and the Tendency for Cancer Programs to Administer Neoadjuvant Chemotherapy for Patients With Advanced Ovarian Cancer https://tinyurl.com/6cmpxrby          Any treatment protocol needs constant reappraisal. Neoadjuvant chemotherapy (Neo) is the use of chemo for ovarian cancer patients  before surgery , at the time of initial presentation. First used for patients who were either too frail or had too big a tumour for surgery, Neo has become more frequent.          Previous studies in 2010 showed no disadvantage in survival. Neo is often preferred because the subsequent surgery is more straightforward with fewer complications. Also logistically it make scheduling surgery simpler. Although generally there has been an increase in the use of Neo, some treatment centres have not done so.          This retrospective stud...