Prognostic significance and accuracy of oncologists' estimates of survival time in recurrent ovarian cancer

Sharon H Nahm; Belinda E Kiely; Rachel L O'Connell; Yeh Chen Lee; Alison Davis; Elisabeth Avall-Lundqvist; Jonathan S Berek; Dominique Berton; Paul Donnellan; Felix Hilpert; Florence Joly; Anne Lanceley; Jonathan A Ledermann; Aikou Okamoto; Amit Oza; Sandro Pignata; Jalid Sehouli; Madeleine T King; Michael Friedlander; Martin R Stockler; Felicia T Roncolato; GCIG Symptom Benefit Group

doi:10.1016/j.ijgc.2024.100030

Prognostic significance and accuracy of oncologists' estimates of survival time in recurrent ovarian cancer

Int J Gynecol Cancer. 2025 Jan;35(1):100030. doi: 10.1016/j.ijgc.2024.100030. Epub 2024 Dec 18.

Authors

Sharon H Nahm¹, Belinda E Kiely², Rachel L O'Connell³, Yeh Chen Lee⁴, Alison Davis⁵, Elisabeth Avall-Lundqvist⁶, Jonathan S Berek⁷, Dominique Berton⁸, Paul Donnellan⁹, Felix Hilpert¹⁰, Florence Joly¹¹, Anne Lanceley¹², Jonathan A Ledermann¹³, Aikou Okamoto¹⁴, Amit Oza¹⁵, Sandro Pignata¹⁶, Jalid Sehouli¹⁷, Madeleine T King¹⁸, Michael Friedlander¹⁹, Martin R Stockler²⁰, Felicia T Roncolato²¹; GCIG Symptom Benefit Group

Affiliations

¹ The NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia; Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; Concord Cancer Centre, Sydney, NSW, Australia.
² The NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia; Concord Cancer Centre, Sydney, NSW, Australia; Macarthur Cancer Therapy Centre, Sydney, NSW, Australia.
³ The NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia.
⁴ The NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia; School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; Department of Medical Oncology, Prince of Wales and Royal Hospital for Women, Sydney, NSW, Australia.
⁵ The Canberra Hospital, Canberra, ACT, Australia; Australian National University, Canberra, ACT, Australia.
⁶ Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden.
⁷ Stanford University School of Medicine, Stanford, California, USA; Stanford Cancer Institute, Stanford, California, USA.
⁸ GINECO Group, Paris, Ile de France, France; Institut de Cancerologie de l'Ouest, Centre René Gauducheau, Saint-Herblain, France.
⁹ Cancer Trials Ireland, University of Galway, Galway, Connacht, Ireland.
¹⁰ Onkologisches Therapiezentrum am Krankenhaus Jerusalem, Hamburg, Germany.
¹¹ GINECO Group, Paris, Ile de France, France; Centre François Baclesse, Caen, Normandy, France; The University of Caen Normandy, Caen, Normandy, France.
¹² Department of Women's Cancer, Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, United Kingdom.
¹³ University College London Cancer Institute, London, United Kingdom; University College London Hospitals, London, United Kingdom.
¹⁴ Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan.
¹⁵ Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
¹⁶ Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, Italy.
¹⁷ Department of Gynecology, Center for Oncological Surgery, Campus Virchow Klinikum, Charité University Hospital Berlin, Berlin, Germany.
¹⁸ School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia.
¹⁹ School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; Department of Medical Oncology, Prince of Wales and Royal Hospital for Women, Sydney, NSW, Australia.
²⁰ The NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia; Concord Cancer Centre, Sydney, NSW, Australia.
²¹ The NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia; Macarthur Cancer Therapy Centre, Sydney, NSW, Australia; Western Sydney University, Department of Medicine, Sydney, NSW, Australia. Electronic address: felicia.roncolato@health.nsw.gov.au.

PMID: 39878283
DOI: 10.1016/j.ijgc.2024.100030

Abstract

Objective: We evaluated the accuracy of oncologists' estimates of expected survival time in recurrent ovarian cancer.

Methods: Oncologists estimated expected survival time at baseline for each patient, who were then followed up for survival time. We hypothesized that oncologists' estimates of expected survival time would be independently significant predictors of survival, unbiased (approximately equal proportions [50%] living longer versus shorter than their expected survival time), or imprecise (<30% within 0.75-1.33 times their observed survival time). We also hypothesized that simple multiples (0.25, 0.5, 2, and 3) of each expected survival time would define ranges that accurately described 3 scenarios for survival time: worst-case (10% of participants with the shortest survival), typical (middle 50%), and best-case (10% with the longest survival) scenarios.

Results: There were 898 participants; the median (interquartile range) for expected survival time was 12 months (range; 8-14) and the median for observed survival time was 13 months (range; 12-14). Oncologists' estimates of expected survival time were independently significant predictors of observed survival time (HR 0.96 per month, 95% CI 0.94-0.98, p < .0001). As hypothesized, 55% lived longer than their expected survival time, 45% shorter than their expected survival time, and 23% of estimates of expected survival time were within 0.75 to 1.33 times their observed survival time. Simple multiples of the expected survival time provided ranges that accurately described 3 scenarios for survival time: 7% of patients died within 0.25 times their expected survival time (worst-case), 53% lived between 0.5 and 2 times their expected survival time (typical), and 13% lived longer than 3 times their expected survival time (best case).

Conclusion: Oncologists' estimates of expected survival time were independently significant predictors of survival time. Simple multiples of the expected survival time provided accurate ranges for scenarios for survival that are useful for explaining prognosis.

Keywords: Quality of Life.

MeSH terms

Adult
Aged
Female
Humans
Middle Aged
Neoplasm Recurrence, Local* / mortality
Neoplasm Recurrence, Local* / therapy
Oncologists*
Ovarian Neoplasms* / diagnosis
Ovarian Neoplasms* / mortality
Ovarian Neoplasms* / pathology
Ovarian Neoplasms* / therapy
Prognosis
Survival Rate