2015-GO Why have OC mortality rates declined Part II. Case-fatality.pdf

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2015-GO Why have OC mortality rates declined Part II. Case-fatality.pdf

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2015-GO Why have OC mortality rates declined Part II. Case-fatality

Gynecologic Oncology 138 (2015) 750–756 Contents lists available at ScienceDirect Gynecologic Oncology j ourna l homepage: www.e lsev ie r .com/ locate /ygynoReview ArticleWhy have ovarian cancer mortality rates declined? Part II. Case-fatalityVictoria Sopik a, Javaid Iqbal a, Barry Rosen b, Steven A. Narod a,c,? a Womens College Research Institute, Womens College Hospital, Toronto Canada b Department of Gynecologic Oncology, Princess Margaret Hospital, Toronto Canada c Dalla Lana School of Public Health, University of Toronto, Toronto Canada H I G H L I G H T S ? The decline in ovarian cancer mortality cannot be explained by a reduction in case-fatality. ? New treatments improve short-term survival and median survival, but not long-term survival or cure. ? The greatest potential for cure appears to be aggressive primary surgery to no residual disease followed by intraperitoneal chemotherapy.? Corresponding author at: Womens College Researc floor, Toronto, ON M5G 1N8, Canada. E-mail address: steven.narod@wchospital.ca (S.A. Nar /10.1016/j.ygyno.2015.06.016 0090-8258/? 2015 Elsevier Inc. All rights reserved.a b s t r a c ta r t i c l e i n f oArticle history: Received 11 April 2015 Received in revised form 9 June 2015 Accepted 12 June 2015 Available online 14 June 2015 Keywords: Ovarian cancer MortalityIn the United States, the age-adjusted mortality rate from ovarian cancer declined by 8% from 1975 to 1991 and by 18% from 1992 to 2011. A decline in the incidence rate of ovarian cancer paralleled the decline in mortality (described in Part I). The decline inmortalitymight also be due to a reduced proportion of ovarian cancer patients who die from their cancer (case-fatality). Here, we examine rates of ovarian cancer case-fatality from the Surveil- lance Epidemiology and End Results (SEER) registry database, and we consider to what extent advances in treat- ment also contribute to the observed decline in mortality. From 1973 to 1999, the five-year case-fatality rate f