靶向治疗时代的卵巢癌生存：德国一项全国性研究

Ovarian cancer treatment has changed substantially over time, through the introduction of bevacizumab and PARP (poly[ADP]-ribose polymerase) (PARP) inhibitors for subsets of cases, added to platinum-based chemotherapies, together with improvements in outcomes of cytoreductive surgery. Population-based studies evaluating survival trends in the context of modern treatment are sparse. Nationwide data from the Center for Cancer Registry Data at the Robert Koch Institute and the Federal Statistical Office of Germany were used. Cases were diagnosed between 2010-2021. Results are presented for cases diagnosed through 2019 to allow for mortality follow-up.Flexible parametric models were used to evaluate three- and five-year relative survival in categories of calendar year from 2010-2012 (largely pre-targeted treatment period), 2013-2016, and 2017-2019 (targeted treatment period). Expected mortality rates were derived from German life tables, stratified by age, calendar year and federal state. A core flexible parametric model was adjusted by age at diagnosis and federal state. We further adjusted for histology and stage. Relative survival was predicted from models for females with a median age at diagnosis (63.5 years), diagnosed in the most common federal state (North Rhine-Westphalia) and for each calendar period, each histological subtype and stage group (I-II, III-IV).A total of 51,985 ovarian cancer cases were included. A total of 75% of cases were of high-grade serous histology. Overall, relative survival improved from the earliest evaluated period to the most recently evaluated period (three-year, 2010-2012=65%, 2017-2019=68%; five-year, 2010-2012=51%, 2017-2019=55%). This difference was evident in particular for stage III and IV disease (three-year, 2010-2012=54%, 2017-2019=58%; five-year, 2010-2012=36%, 2017-2019=40%), with improvements observed across histotype. Three-year relative survival for the predominant stage III and IV high-grade serous histotype increased from 54% to 57% across the study period, with a corresponding increase in five-year net survival of 36% to 40%.Ovarian cancer survival improved across the evaluated periods. These improvements are likely related to advancements in achieving minimal residual disease during cytoreductive surgery, given the improvements observed across histotype, together with the introduction of targeted therapies for select disease subgroups.