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Ovarian Cancer Outlook and Prognosis

Posted on August 03, 2021
Medically reviewed by
Howard Goodman, M.D.
Article written by
Maureen McNulty

If you have been diagnosed with ovarian cancer, you may want to know more about your expected prognosis (outlook). Your prognosis describes how likely you are to recover or to have a relapse (have your cancer come back). Doctors estimate your prognosis based on survival rates and your characteristics. Talk to your health care team to find out more about what to expect from ovarian cancer. Your doctors know your health history and can help you better understand your outlook.

Ovarian Cancer Survival Rates

Researchers use survival rates to describe outcomes among large groups of people who have the same type of cancer. Survival rates don’t say how long any one person will live. Instead, they provide clues as to whether certain types of cancer are easier or harder to treat. Survival statistics are often reported as a five-year relative survival rate. This number describes how likely a person with ovarian cancer is to live for five years or more, compared to people without this condition.

Survival rates for ovarian cancer change depending on how advanced the cancer is. When reporting survival statistics, researchers divide ovarian cancer into three groups:

  • Localized — Cancer is only in the ovaries.
  • Regional — Cancer has grown into nearby tissues or lymph nodes in the pelvis.
  • Distant — Cancer has metastasized (spread) to more distant parts of the body.

Ovarian cancer survival rates are also based on the type of ovarian cancer. There are three main types of ovarian cancer: epithelial ovarian cancer, stromal cell ovarian cancer, and germ cell ovarian cancer. Cancers that develop in the fallopian tubes (tubes that connect the ovaries to the uterus) and peritoneum (lining of the abdomen) are also usually grouped with epithelial ovarian cancer.

Survival Rates for Epithelial Ovarian Cancer

Epithelial ovarian cancers begin in the epithelial cells found on the outer surface of the ovaries. They are the most common type of ovarian cancer and can be more aggressive.

Overall, epithelial ovarian cancers have a five-year relative survival rate of 48 percent. This means that on average, people with epithelial ovarian tumors are about half as likely as people without this cancer to live at least five years. However, a person’s prognosis also depends on how far cancer has spread. The five-year relative survival rates for different stages are:

  • Localized epithelial ovarian cancer — 93 percent
  • Regional epithelial ovarian cancer — 75 percent
  • Distant epithelial ovarian cancer — 31 percent

Survival Rates for Germ Cell Ovarian Cancer

Germ cell ovarian cancers begin in cells in the ovary that make the eggs. Germ cell tumors are much more common in children or young women. The outlook for people with ovarian germ cell cancer is usually quite good.

The five-year relative survival rate for all stages of germ cell tumors is 93 percent. People with this condition are 93 percent as likely to live for five years or more, compared to people without germ cell tumors of the ovary. The five-year relative survival rates for each stage of germ cell ovarian cancers are:

  • Localized germ cell tumors — 98 percent
  • Regional germ cell tumors — 94 percent
  • Distant germ cell tumors — 73 percent

Survival Rates for Stromal Cell Ovarian Cancer

Stromal cell ovarian cancers begin in cells that make up the connective tissue. Connective tissue connects all of the other cells within the ovary and makes hormones. Stromal tumors often grow slowly.

Stromal cell ovarian cancers have a five-year relative survival rate of 88 percent, which means that people with stromal cancers are 88 percent as likely as those without to live for five years or more. The relative five-year survival rate varies among different disease stages:

  • Localized stromal cell cancers — 98 percent
  • Regional stromal cell cancers — 89 percent
  • Distant stromal cell cancers — 60 percent

Survival Rates for Fallopian Tube Cancer

Fallopian tube cancer begins in the cells that make up the fallopian tubes. This type of cancer is rare.

The five-year relative survival rate for all stages of fallopian tube cancer is 57 percent. People diagnosed with this type of cancer are a little more than half as likely to live for five years or more, compared to people without fallopian tube cancer. The five-year relative survival rates by stage are:

  • Localized fallopian tube cancers — 95 percent
  • Regional fallopian tube cancers — 53 percent
  • Distant fallopian tube cancers — 45 percent

Survival Rates for Primary Peritoneal Cancer

Primary peritoneal cancer develops in the tissue that lines the abdomen. Peritoneal cancer looks and acts like epithelial ovarian cancer and may have similar survival rates.

Survival rates for other ovarian cancers are reported using the Surveillance, Epidemiology, and End Results (SEER) database. However, the SEER database does not report survival statistics for primary peritoneal cancers on their own. Other scientific studies have analyzed the prognosis for peritoneal cancers, but they do not report results in the same way.

Researchers consider primary peritoneal tumors to be advanced cancers. This means that, as with people with advanced epithelial cancers, those with primary peritoneal cancers often have a poor prognosis. One cancer research study found that people with primary peritoneal cancer live for a median of 23.1 months after being diagnosed. This means that half of the people with this type of cancer live for about two years. However, another more recent study found that people with primary peritoneal cancer lived for an average of 46 months, or close to four years. This does not mean that people with primary peritoneal cancer will die in 46 months. Some may live for many more years or may achieve remission (meaning all signs of the cancer may disappear). Others will not do as well and may die within the first one or two years. These numbers show that treatments for peritoneal cancer are improving and allowing people to live longer. To better understand what your outcome may be, talk to your health care team.

Ovarian Cancer Prognostic Factors

Prognostic factors make it more or less likely that a person will have a good outcome after being treated for a condition. Ovarian cancer prognostic factors include cancer stage, cancer type, cancer grade, age, overall health, certain signs or symptoms, and the effectiveness of treatments.

Stage of Ovarian Cancer

The stage of ovarian cancer describes how far it has spread. When reporting survival rates, researchers often describe stages as localized, regional, or distant. However, when staging a person’s cancer, doctors classify stages of ovarian cancer using a scale from 1 to 4. Stage 1 ovarian cancer has been diagnosed in its early stages. Stages 3 and 4 cancer are advanced. The higher a cancer’s stage is, the harder it is to treat and the worse a person’s outcome is likely to be.

Type of Ovarian Cancer

Survival rates show that people with stromal cell or germ cell cancer have a better prognosis than those with epithelial cancer. One reason for this is that these different types of cancer tend to be caught at different stages. About 70 percent of epithelial ovarian cancers are not caught until after they have reached advanced stages and have begun to spread. On the other hand, stromal and germ cell tumors are much more likely to be detected during the early stages of the disease.

Some subtypes of epithelial cancer are known to lead to a worse prognosis. Regarding early-stage tumors, people with endometrioid cancers tend to be more likely to relapse. On the other hand, the mucinous subtype may lead to the best survival rate.

Ovarian Cancer Grade

The grade of cancer describes how quickly the cancer cells are dividing and spreading. People with high-grade (grade 2 or 3) ovarian cancer may have a worse prognosis.

Age

Younger people have better survival rates than older people. People under the age of 65 are less likely to have a relapse, and they have better survival rates.

Overall Health

People who are in good health are more likely to have better outcomes. Doctors often measure overall health using a term called performance status. A person’s performance status describes how well they can complete daily activities. People who have a poor performance status may not be able to tolerate aggressive treatments.

Ovarian Cancer Signs and Symptoms

People who have pelvic pain as an ovarian cancer symptom have a better chance of living longer. However, those who have ascites (buildup of fluid in the abdomen) have a worse prognosis. Additionally, doctors measure blood levels of a protein called CA-125 when diagnosing ovarian cancer. The higher a person’s CA-125 level is, the more likely they are to have aggressive cancer that doesn’t respond to treatment.

How Cancer Responds to Treatment

Doctors may be able to provide more information about prognosis as a person goes through ovarian cancer treatments. One common ovarian cancer treatment is debulking surgery. If surgeons can remove the vast bulk of the tumor, and if surgery doesn’t cause any complications (additional health conditions), then a person has a better prognosis. Additionally, if a person’s signs of cancer decrease after undergoing chemotherapy, they may be more likely to have a better outcome.

The Outlook for Ovarian Cancer Is Improving

Researchers are constantly studying ovarian cancer and its treatments. As a result, treatments have been improving, and people are living longer with ovarian cancer than they used to. Ovarian cancer death rates (the number of people who die from this condition) have decreased by 2.3 percent each year for the past decade.

The survival rates that you are seeing now are based on information from people who were diagnosed with cancer from 2010 to 2016. Death rates have improved since then, so people who are receiving an ovarian cancer diagnosis now may have better outcomes than what these survival rates show.

Talk With Others Who Understand

MyOvarianCancerTeam is the social network for people with ovarian cancer and their loved ones. On MyOvarianCancerTeam, more than 2,000 members come together to ask questions, give advice, and share their stories with others who understand life with ovarian cancer.

Are you living with ovarian cancer? Share your experiences in the comments below, or start a conversation by posting on your Activities page.

All updates must be accompanied by text or a picture.
Howard Goodman, M.D. is certified by the American Board of Obstetrics and Gynecology and specializes in the surgical management of women with gynecologic cancer. Review provided by VeriMed Healthcare Network.. Learn more about him here.
Maureen McNulty studied molecular genetics and English at Ohio State University. Learn more about her here.

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