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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Risk factors for early death among ovarian cancer patients: a nationwide cohort study

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  3. Prognostic utility of serum YKL-40 in patients with cervical cancer

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OBJECTIVE: To characterize ovarian cancer patients who die within 6 months of diagnosis and to identify prognostic factors for these early deaths.

METHODS: A nationwide cohort study covering ovarian cancer in Denmark in 2005-2016. Tumor and patient characteristics including comorbidity and socioeconomic factors were obtained from the comprehensive Danish national registers.

RESULTS: A total of 5,570 patients were included in the study. Three months after ovarian cancer diagnosis 456 (8.2%) had died and 664 (11.9%) died within 6 months of diagnosis. Adjusted for age and comorbidity, patients who died early were admitted to hospital significantly more often in a 6-month period before the diagnosis (odds ratio [OR]=1.61 [1.29-2.00], and OR=1.47 [1.21-1.78]), for patients who died within 3 and 6 months respectively). Low educational level (OR=2.11), low income (OR=2.50) and singlehood (OR=1.90) were factors significantly associated with higher risk of early death. The discriminative ability of risk factors in identifying early death was assessed by cross-validated area under the receiver operating characteristic curve (AUC). The AUC was found to be 0.91 (0.88-0.93) and 0.90 (0.87-0.92) for death within 3 and 6 months, respectively.

CONCLUSIONS: Despite several admissions to hospital, the ovarian cancer diagnosis is delayed for a subgroup of patients, who end up dying early, probably due to physical deterioration in the ineffective waiting time. Up to 90% of high-risk patients might be identified significantly earlier to improve the prognosis. The admittance of the patients having risk symptoms should include fast track investigation for ovarian cancer.

Original languageEnglish
JournalJournal of Gynecologic Oncology
Volume31
Issue number3
Pages (from-to)e30
ISSN2005-0380
DOIs
Publication statusPublished - May 2020

ID: 61423742