# A Survival Analysis of Patients with Recurrent Epithelial Ovarian Cancer Based on Relapse Type: A Multi-Institutional Retrospective Study in Armenia

## TL;DR

This study examines survival outcomes of ovarian cancer patients in Armenia based on recurrence type and treatment, highlighting poor survival rates and the need for better therapies.

## Contribution

The study provides survival data for recurrent ovarian cancer patients in Armenia, focusing on platinum sensitivity and treatment outcomes.

## Key findings

- Platinum-sensitive relapse was more common (81.6%) compared to platinum-resistant relapse (18.4%).
- Patients with platinum-sensitive relapse had significantly better post-progression survival (54 months) than those with platinum-resistant relapse (25 months).
- Low survival rates emphasize the urgent need for improved treatment options in resource-limited settings.

## Abstract

Background: Annually, approximately 200 new ovarian cancer cases are diagnosed in Armenia, which is considered an upper-middle-income country. This study aimed to summarize the survival outcomes of patients with relapsed ovarian cancer in Armenia based on the type of recurrence, risk factors, and choice of systemic treatment. Methods: This retrospective case-control study included 228 patients with relapsed ovarian cancer from three different institutions. Results: The median age of the patients was 55. The median follow-up times from relapse and primary diagnosis were 21 and 48 months, respectively. The incidence of platinum-sensitive relapse was 81.6% (186), while platinum-resistant relapse was observed in only 18.4% (42) of patients. The median post-progression survival of the platinum-sensitive group compared to the platinum-resistant group was 54 vs. 25 months (p < 0.001), respectively, while the median survival after relapse was 25 vs. 13 months, respectively; three- and five-year post-progression survival rates in these groups were 31.2% vs. 23.8%, and 15.1% vs. 9.5%, respectively (p = 0.113). Conclusions: Overall, despite new therapeutic approaches, ovarian cancer continues to be one of the deadly malignant diseases affecting women, especially in developing countries with a lack of resources, where chemotherapy remains the primary available systemic treatment for the majority of patients. Low survival rates demonstrate the urgent need for more research focused on this group of patients with poor outcomes.