Ovarian cancer is the leading cause of death of all gynecologic malignancies in the developing world. Despite the advances in chemotherapeutic agents and treatment modalities for patients with ovarian cancer, the mortality rate has not changed significantly over the past twenty years. Studies continue to evaluate varying treatment strategies to improve clinical outcomes in patients with ovarian cancer.

Randomized controlled trials can assess the efficacy of a treatment regimen in selected populations of patients and practitioners, but these studies do not necessarily evaluate the effectiveness of a treatment in the “real-world.” The use of large databases of patients undergoing treatment for ovarian cancer deepens our understanding of the practical effectiveness of a treatment and provides additional information on outcomes that may not be measurable in a randomized controlled trial.

By using the ovarian cancer database at our institution combined with the provincial cancer registry, we plan on studying a number of aspects of clinical health outcomes in this population. We are currently evaluating survival outcomes of patients with less common histologic types of ovarian cancer, such as endometrioid compared to serous tumor pathologies. Our large database contains experience from over twenty years of patient care which allows us to make meaningful comparisons between these cohorts. Future studies will include the role of optimal surgical staging of early stage ovarian cancers in determining adjuvant treatment options, the outcomes associated with neoadjuvant chemotherapy compared to primary surgical debulking, and use of radiation in early stage tumors. The outcomes will be obtained by considering all important prognostic factors, adjusting for these factors by multivariate regression analyses, and incorporating the appropriate use of propensity scores and sensitivity analyses.

This research will continue to generate hypotheses related to possible treatment strategies in ovarian cancer and potentially help to improve the survival outcomes for patients suffering from ovarian cancer.