Prognostic factors in early-stage ovarian cancer

Background. Stage I–II ovarian cancer (OC) is characterized by a relatively favorable prognosis; however, 20–30 % of patients experience recurrence. Controversies regarding the optimal treatment strategy persist, underscoring the need for precise risk stratification based on clinicopathological characteristics. Aim. To evaluate the impact of clinicopathological characteristics on disease outcomes. Materials and methods. A retrospective analysis included data of 209 patients with stage I–II OC treated between 1990 and 2019. Staging was based on the FIGO 2016 classification. Survival was analyzed using the Kaplan–Meier method, with group comparisons made by the log-rank test. Multivariate analysis was performed using Cox regression. Results. The median age was 50.1 years. Multivariate analysis identified age over 40 years as an independent predictor of poor prognosis, increasing the risk of death (hazard ratio (HR) 4.1; 95 % confidence interval (CI) 1.37–12.23; p = 0.011) and disease progression (HR 2.27; 95 % CI 1.03–4.98; p = 0.042). Significant survival differences were observed based on histological type of OC. Endometrioid (HR 0.24; 95 % CI 0.10–0.60; p = 0.002) and mucinous (HR 0.33; 95 % CI 0.12–0.92; p = 0.035) types were associated with significantly better progression-free survival compared to high-grade serous carcinoma. Low tumor grade (G3) was associated with a substantial increase in the risk of death (HR 3.50; 95 % CI 1.56–7.85) and progression (HR 2.92; 95 % CI 1.57–5.45) compared to G1. Conclusion. Age over 40 years, high-grade serous histological type, and low tumor grade (G3) are independent prognostic factors for an unfavorable outcome in stage I–II OC. These findings highlight the importance of incorporating these parameters into risk stratification models to guide personalized treatment strategies.