Factors Associated with Survival Outcomes in Ovarian Cancer Patients in Karachi, Pakistan: Results from a Single-Institution Cancer Registry

Objective: To evaluate survival outcomes and identify sociodemographic and clinicopathological factors associated with survival among women diagnosed with ovarian cancer (OC) in Karachi, Pakistan. Study Design: Retrospective cohort study. Place and Duration of the Study: The Aga Khan University Hospital, Karachi, Pakistan, between 2010 and 2020. Methodology: A total of 966 women aged 18–91 years with OC were identified from the University Hospital cancer registry. Data on vital status and last contact dates were updated. Sociodemographic characteristics, tumour features, stage, CA125 levels, and treatment modalities were analysed. Survival was assessed as the primary endpoint using Kaplan-Meier survival analysis and Cox proportional hazards models, with hazard ratios (HR) and 95% confidence intervals (CI) reported. Results: Patients who did not undergo cytoreductive surgery exhibited the highest mortality risk (HR: 3.94; CI: 2.69–5.76), followed by those who underwent suboptimal cytoreduction surgery (HR: 2.01; CI: 1.29–3.13) compared to those who underwent optimal cytoreduction surgery. Chemotherapy significantly reduced mortality risk (HR: 0.56; CI: 0.39–0.82). Recurrence was a critical determinant of poor survival, with the highest risk observed in patients who were never disease-free (HR: 10.81; CI: 6.12–19.07) or experienced recurrence (HR: 7.44; CI: 4.31–12.86). Conclusion: Optimal cytoreduction surgery and chemotherapy are essential in improving survival outcomes for OC patients. Recurrence remains a significant determinant of poor prognosis. Enhancing early detection, optimising treatment strategies, and strengthening healthcare infrastructure are critical for improving survival outcomes among OC patients in Karachi.