Prediction and Validation of Influential Features in Prognostic Survival Against Serous Ovarian Cancer

Background: Current evidence on prognostic factors affecting outcomes in serous ovarian cancer (SOC) is limited, with many studies evaluating only a narrow range of variables. This study aimed to assess survival patterns and prognostic determinants among SOC patients treated at our institution. Methods: We conducted a retrospective analysis of women diagnosed with SOC based on histopathological and cytopathological analyses between January 2016 and December 2023. The collected data included demographic characteristics, comorbidities, laboratory parameters, histological grade, tumour stage, surgical approach, postoperative residual disease, chemotherapy regimens, targeted therapy use, postoperative complications, and clinical outcomes. The primary endpoints were overall survival (OS) and mortality. Results: A total of 302 patients with SOC were included, with a median age of 52 years (mean 51.4 ± 10.0 years). Of these, 116 patients (38.4%) had high-grade serous ovarian cancer (HGSOC), and 119 patients (39.4%) were at clinicopathological stages III/IV. Comorbidities were present in 32.1% of patients but did not significantly affect survival. Multivariate analysis identified the following independent prognostic factors (ranked by hazard ratio): human epididymis protein 4 (HE4) positivity (hazard ratio [HR] = 1.856), tumour stage (HR = 2.411), histological grade (HR = 3.415), achieving R0 resection status (HR = 3.316), use of targeted therapies (HR = 4.498), and adequacy of chemotherapy cycles (HR = 2.663). Conclusions: OS in SOC was significantly influenced by HE4 expression, tumour stage, histological grade, surgical resection status, targeted therapy, and the number of chemotherapy cycles (p < 0.05). These findings highlight the importance of early diagnosis, optimal cytoreduction, complete chemotherapy, and incorporation of targeted treatments to improve patient outcomes.