Prognostic prediction of survival in people with ovarian cancer: a palliative approach

Abstract

Introduction: in recent years, the clinical prediction of survival, defined as the physician's ability to estimate the probable or remaining survival of the patient, has acquired more interest than in the past, however, it remains influenced by the experience of the operator and is poorly reproducible. Globally, ovarian cancer is the seventh leading cause of cancer death among women and survival is very poor due to difficulties in detection, diagnosis, and treatment. Prognostic information close to reality is a determining tool for decision-making for both doctors and patients. The objective of this review was to review the different tools that exist to determine a survival prognosis in people with cancer in its terminal stage, from a palliative approach and to emphasize women with ovarian cancer. Methodology: a narrative review study was carried out based on scientific articles relevant to the subject, published between 1994 and 2016 in English and Spanish, available in the following databases: Scielo, Google Academic, PubMed, using as descriptors the words prognosis OR survival AND palliative care AND cancer OR ovarian cancer. Results: some studies show that in early stages of epithelial ovarian carcinoma, people with the clear cell subtype have a worse prognosis than those with serous carcinoma. Staging is a prognostic factor recognized by previous studies and has been found to have a significant impact on survival in people with epithelial ovarian carcinoma. However, other studies show that age at diagnosis is another important prognostic factor, becoming a negative prognostic factor as the person advances in age. The disparity in prognosis is very wide depending on the stage of the disease, which is the most important prognostic variable for survival of the disease. Better performance status generally confers greater tolerance to various therapeutic modalities, from surgery to chemotherapy, and induces physicians to use treatments that are more aggressive. Conclusion: Papscore scale is one of the most reliable for determining the survival prognosis of patients with ovarian cancer, since it includes several basic clinical and laboratory parameters, it is easy to apply, accurate and valid. The FIGO staging system is a prognostic factor of independent significance. Both are useful tools in predicting the survival prognosis of patients with ovarian cancer.