An NCDB analysis on the demographic, treatment, and survival of ovarian papillary mucinous cystadenocarcinoma.

Abstract

e17540 Background: Ovarian papillary mucinous cystadenocarcinoma (OPMC) originates from the germinal epithelium by metaplasia with slow development accompanied with harmful impacts. Given that OPMC often presents with vague or nonspecific symptoms and shares overlapping histologic characteristics with other tumors of the ovary, the diagnostic process is particularly challenging. While literature is limited on the mortality rate in OPMC, 5-year mortality rates for other mucinous papillary lesions stand at 60%. Due to the rarity of OPMC, this study leverages the NCDB to analyze trends in patients that could present information of OPMC’s epidemiology. Methods: Utilizing the 2004-2020 NCDB, a retrospective cohort analysis was conducted of patients with a histologically-confirmed diagnosis of OPMC using the ICD-O-3 code 8471 (N = 218). Descriptive statistics were used to characterize demographic (age, sex, race, Hispanic status) and socioeconomic factors (income, insurance, etc). Incidence trends and survival analysis were conducted using regression and Kaplan-Meier statistics. Results: Our cohort identified 218 patients with a confirmed diagnosis of OPMC, with a strong decline in annual incidence between 2004 and 2020 (R^2 = 0.866). Most patients were diagnosed at stage I (43.6%) with the ovary as the primary site (70.2%). Most patients were non-Hispanic (85.3%), White (83.0%), and female (89.0%), and had a Charlson-Deyo co-morbidity score of 0 (79.8%). The mean age at diagnosis was 57.4 (SD = 17.0). Socioeconomically, patients were primarily privately insured (48.2%) or using Medicare (35.3%) with more than half of patients (55.5%) living in counties in metropolitan areas with a population of >1 million. For primary treatment, the majority of patients (91.3%) received surgery, while 40.4% also received chemotherapy, and 6% also received radiation therapy. The 30-day mortality rate was 2.3% with a 90-day mortality rate of 5.5%. The surgical margin of primary site was majority (61.9%) no residual tumor. The 2-year, 5-year, and 10-year survival rates were 90.2% (SE = 0.020), 76.8% (SE = 0.03) and 59.9% (SE = 0.04) respectively, with the mean survival time being 125.3 months (SD = 6.2). Conclusions: This study represents the first NCDB analysis of OPMC, addressing a substantial gap in literature. Patients are usually diagnosed in middle adulthood with the primary site being the ovary area, this is consistent with prior literature. This analysis is the first to exhibit that the majority of surgery performed on the primary site resulted in no residual tumor. The extent of impact that demographic and socioeconomic factors have on the diagnosis, treatment, and overall survival rate of PMC patients warrants further studies.