Hidden in plain sight – Survival consequences of baseline symptom burden in women with recurrent ovarian cancer
Abstract
OBJECTIVE: To describe the baseline symptom burden(SB) experienced by patients(pts) with recurrent ovarian cancer(ROC) prior and associations with progression free survival (PFS) and overall survival (OS). METHODS: We analysed baseline SB reported by pts. with platinum resistant/refractory ROC (PRR-ROC) or potentially‑platinum sensitive ROC receiving their third or greater line of chemotherapy (PPS-ROC≥3) enrolled in the Gynecologic Cancer InterGroup - Symptom Benefit Study (GCIG-SBS) using the Measure of Ovarian Symptoms and Treatment concerns (MOST). The severity of baseline symptoms was correlated with PFS and OS. RESULTS: The 948 pts. reported substantial baseline SB. Almost 80% reported mild to severe pain, and 75% abdominal symptoms. Shortness of breath was reported by 60% and 90% reported fatigue. About 50% reported moderate to severe anxiety, and 35% moderate to severe depression. Most (89%) reported 1 or more symptoms as moderate or severe, 59% scored 6 or more symptoms moderate or severe, and 46% scored 9 or more symptoms as moderate or severe. Higher SB was associated with significantly shortened PFS and OS; five symptoms had OS hazard ratios larger than 2 for both moderate and severe symptom cut-offs (trouble eating, vomiting, indigestion, loss of appetite, and nausea; p < 0.001). CONCLUSION: Pts with ROC reported high SB prior to starting palliative chemotherapy, similar among PRR-ROC and PPS-ROC≥3. High SB was strongly associated with early progression and death. SB should be actively managed and used to stratify patients in clinical trials. Clinical trials should measure and report symptom burden and the impact of treatment on symptom control.
Related
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BibTeX
@article{roncolato2026hidden,
title = {{Hidden in plain sight – Survival consequences of baseline symptom burden in women with recurrent ovarian cancer}},
author = {Felicia Roncolato and Madeleine King and Rachel O'Connell and Yeh Chen Lee and Florence Joly and Felix Hilpert and Anne Lanceley and Yoshio Yoshida and Jane Bryce and Paul Donnellan and Amit Oza and Elisabeth Avall-Lundqvist and Jonathan Berek and Jonathan Ledermann and Dominique Berton and Jalid Sehouli and Marie-Christine Kaminsky and Martin Stockler and Michael Friedlander},
journal = {Gynecologic Oncology},
year = {2026},
month = sep,
doi = {10.1016/j.ygyno.2024.02.025},
url = {https://hal.science/hal-05746190v1},
note = {CC BY},
}
RIS
TY - JOUR
TI - Hidden in plain sight – Survival consequences of baseline symptom burden in women with recurrent ovarian cancer
AU - Felicia Roncolato
AU - Madeleine King
AU - Rachel O'Connell
AU - Yeh Chen Lee
AU - Florence Joly
AU - Felix Hilpert
AU - Anne Lanceley
AU - Yoshio Yoshida
AU - Jane Bryce
AU - Paul Donnellan
AU - Amit Oza
AU - Elisabeth Avall-Lundqvist
AU - Jonathan Berek
AU - Jonathan Ledermann
AU - Dominique Berton
AU - Jalid Sehouli
AU - Marie-Christine Kaminsky
AU - Martin Stockler
AU - Michael Friedlander
PY - 2026
DA - 2026/09/11
JO - Gynecologic Oncology
DO - 10.1016/j.ygyno.2024.02.025
UR - https://hal.science/hal-05746190v1
AB - OBJECTIVE: To describe the baseline symptom burden(SB) experienced by patients(pts) with recurrent ovarian cancer(ROC) prior and associations with progression free survival (PFS) and overall survival (OS). METHODS: We analysed baseline SB reported by pts. with platinum resistant/refractory ROC (PRR-ROC) or potentially‑platinum sensitive ROC receiving their third or greater line of chemotherapy (PPS-ROC≥3) enrolled in the Gynecologic Cancer InterGroup - Symptom Benefit Study (GCIG-SBS) using the Measure of Ovarian Symptoms and Treatment concerns (MOST). The severity of baseline symptoms was correlated with PFS and OS. RESULTS: The 948 pts. reported substantial baseline SB. Almost 80% reported mild to severe pain, and 75% abdominal symptoms. Shortness of breath was reported by 60% and 90% reported fatigue. About 50% reported moderate to severe anxiety, and 35% moderate to severe depression. Most (89%) reported 1 or more symptoms as moderate or severe, 59% scored 6 or more symptoms moderate or severe, and 46% scored 9 or more symptoms as moderate or severe. Higher SB was associated with significantly shortened PFS and OS; five symptoms had OS hazard ratios larger than 2 for both moderate and severe symptom cut-offs (trouble eating, vomiting, indigestion, loss of appetite, and nausea; p < 0.001). CONCLUSION: Pts with ROC reported high SB prior to starting palliative chemotherapy, similar among PRR-ROC and PPS-ROC≥3. High SB was strongly associated with early progression and death. SB should be actively managed and used to stratify patients in clinical trials. Clinical trials should measure and report symptom burden and the impact of treatment on symptom control.
SN - 0090-8258
SN - 1095-6859
ER -