Tilbakefall av eggstokkreft og borderline tumorer i eggstokkene i Norge

Abstract

ENGLISH SUMMARY

Paulsen T.

Recurrence of ovarian cancer and borderline ovarian tumours in Norway.

Nor J Epidemiol

Background:

Introduction:

Aim:

Controversies:

Material and method:

Scientific significance:

Plan of progress:

The project is estimated to take three years. The new form in the pilot-project will be in

use from the middle of October 2001. The new form will be evaluated in January 2002. A new permanent

form will then be worked out according to the experience from the pilot-form. After the end of the project in

three years, we will further analyse the 5-year relative survival.

The aim of the project is to improve the quality of the data and give better knowledge

about course and treatment of women with recurrence of ovarian cancer and BOT in Norway.

All women with diagnosed ovarian/tube/perinoneal cancer and BOT as primary

disease or recurrence in Norway will be included in this study. About 500 women are diagnosed with

ovarian cancer annually and 330 women with recurrence. The number of BOT is approximately 130 per

year. A new registration form will be sent to all hospitals in Norway with gynaecological departments. The

form consists of clinical and pathological data. In addition we will select paraffin-embedded microscope

slides of BOT in the histological archive of the Norwegian Radium hospital; one group with primary disease

and one group with recurrence. We will compare immunohistological characteristics of these two groups.

Only a few prospective protocols have been planned or carried out internationally that were

randomised for different treatments of recurrent ovarian cancer. The studies that have been carried out have

included only a few patients. In our project we will collect clinical information from the whole population of

women with ovarian cancer and BOT in Norway. Surgery of women with recurrence of ovarian cancer in

order to achieve tumour reduction is still controversial. Some authors claim that tumour reduction surgery

improves the survival of these patients, but this is not proven. Some authors indicate that elderly patients

may receive less surgical and chemotherapeutic treatment without obvious clinical rationale. Today we do

not know which treatment of recurrence of ovarian cancer gives the longest survival and best quality of life.

The incorporation of paclitaxel into first-line therapy improves the duration of progression-free survival and

overall survival in women with incompletely-resected stage III and stage IV ovarian cancer. However we do

not know which treatment gives the best overall survival in the case of recurrence. BOT are different from

the invasive tumours of the ovary, with longer relative 5-year survival. BOT stage I has relative 5-year

survival of 99% and for the advanced stages 92%. Probably BOT develop through accumulation of different

genetic mutations than invasive epithelial ovarian tumours.

The main aim of this extended registration of ovarian cancer and BOT in Norway is to better document

diagnostic procedures and treatment. We will emphasise the recurrence of ovarian cancer and BOT.

The age-standardised incidence rate for ovarian cancer has increased from 11.9 per 100 000

person-years in 1957 to 13.3 per 100 000 in 1997. The incidences in the Nordic countries, with the exception

of Finland, are among the highest in the world. The borderline ovarian tumours (BOT) had an incidence rate

of 4.8 per 100 000 in the period 1970 to 1993.

The 5-year relative survival for patients with ovarian cancer in Norway has improved over

time, but is still less than 40%. Early diagnosis and optimal therapy can hopefully better the prognosis. In

order to improve the techniques of examination, treatment and follow-up of these patients, the establishment

of a system for quality insurance of clinical data for cancer in Norway (NOU 20, 1997) has been suggested.

According to the answers of a questionnaire that was sent to the gynaecological departments in Norway in

the spring of 2000, there were differences in how hospitals handle ovarian cancer patients.

2001; 11 (2): 143-146.