Tilbakefall av eggstokkreft og borderline tumorer i eggstokkene i Norge

Abstract

ENGLISH SUMMARYPaulsen 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 inuse from the middle of October 2001. The new form will be evaluated in January 2002. A new permanentform will then be worked out according to the experience from the pilot-form. After the end of the project inthree 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 knowledgeabout 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 primarydisease or recurrence in Norway will be included in this study. About 500 women are diagnosed withovarian cancer annually and 330 women with recurrence. The number of BOT is approximately 130 peryear. A new registration form will be sent to all hospitals in Norway with gynaecological departments. Theform consists of clinical and pathological data. In addition we will select paraffin-embedded microscopeslides of BOT in the histological archive of the Norwegian Radium hospital; one group with primary diseaseand 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 wererandomised for different treatments of recurrent ovarian cancer. The studies that have been carried out haveincluded only a few patients. In our project we will collect clinical information from the whole population ofwomen with ovarian cancer and BOT in Norway. Surgery of women with recurrence of ovarian cancer inorder to achieve tumour reduction is still controversial. Some authors claim that tumour reduction surgeryimproves the survival of these patients, but this is not proven. Some authors indicate that elderly patientsmay receive less surgical and chemotherapeutic treatment without obvious clinical rationale. Today we donot 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 andoverall survival in women with incompletely-resected stage III and stage IV ovarian cancer. However we donot know which treatment gives the best overall survival in the case of recurrence. BOT are different fromthe invasive tumours of the ovary, with longer relative 5-year survival. BOT stage I has relative 5-yearsurvival of 99% and for the advanced stages 92%. Probably BOT develop through accumulation of differentgenetic mutations than invasive epithelial ovarian tumours.The main aim of this extended registration of ovarian cancer and BOT in Norway is to better documentdiagnostic 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 000person-years in 1957 to 13.3 per 100 000 in 1997. The incidences in the Nordic countries, with the exceptionof Finland, are among the highest in the world. The borderline ovarian tumours (BOT) had an incidence rateof 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 overtime, but is still less than 40%. Early diagnosis and optimal therapy can hopefully better the prognosis. Inorder to improve the techniques of examination, treatment and follow-up of these patients, the establishmentof 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 inthe spring of 2000, there were differences in how hospitals handle ovarian cancer patients.2001; 11 (2): 143-146.