A diagnosis of stage 4 ovarian cancer means the cancer has spread to other parts of your body. Factors like your age, treatment type, and overall health may affect survival rate for this type of cancer.

Ovarian cancer is a common type of cancer that grows in your ovaries. In the United States, ovarian cancer is the fifth leading cause of cancer-related death among women.

Stage 4, where the cancer has spread to other organs and areas of your body, is the most advanced stage of ovarian cancer.

This diagnosis may feel frightening and overwhelming, to say the very least — especially if you begin searching for information on survival rates for this type of cancer.

Survival rate tells you what percentage of people with the same type and stage of cancer are still alive after a certain time period following diagnosis. Relative survival rate compares this number to the survival rate for people who don’t have that cancer.

The American Cancer Society (ACS) lists the 5-year relative survival rate for distant (stage 4) ovarian cancers as follows:

  • Invasive epithelial ovarian cancer: 31%
  • Ovarian stromal tumors: 70%
  • Germ cell tumors of your ovary: 74%
  • Fallopian tube cancer: 44%

It’s important to keep in mind, though, that survival rates can’t predict exactly how long you, yourself, will live after your diagnosis. After all, you’re an individual person, not just a number — and a number of factors can play a part in your outlook.

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The survival rate for stage 4 ovarian cancer can depend on several key factors, including:

Your age

According to a 2019 review, a younger age may improve your chances of surviving any stage of ovarian cancer. Researchers found that people over the age of 64 are less likely to survive.

Younger people can often receive more aggressive treatment with surgery and chemotherapy, which may explain why they have a better survival rate, says Dr. Clare Bertucio, a radiation oncologist, women’s health specialist, and the CEO of Med Mama.

“In general, the younger the patient, the better they’re able to withstand the stress that cancer takes on the body,” says Dr. Kendra Outler, a board certified anesthesiologist at Walter Reed National Military Medical Center.

Treatment type

The treatment you choose for stage 4 ovarian cancer — and how well your cancer responds to the treatment — can greatly affect your survival rate, Outler says.

A 2020 study compared three types of treatment for 208 people with stage 4 ovarian cancer:

  • 65 people received chemotherapy only
  • 52 people received surgery as a first-line treatment
  • 91 people received chemotherapy first and then surgery

The study authors found that surgery greatly improved survival outcomes. What’s more, the cancer was less likely to progress further after surgery.

According to a large 2021 study, women with stage 3 or 4 ovarian cancer who receive chemotherapy treatment before surgery have greater short-term survival rates than those who receive surgery before chemotherapy.

Treatments continue to improve over time. So, you may have a better outlook than people who received a diagnosis years ago — evidence suggests people with a diagnosis of ovarian cancer live longer than ever before.

Other conditions and overall health

Your overall health may also play a role in your outlook, according to Dr. Yevgeniya Ioffe, chief of gynecologic oncology at Loma Linda University Cancer Center.

  • Existing health conditions: According to a 2021 study, diabetes and heart disease can both negatively affect survival rates for people with advanced-stage ovarian cancer.
  • Frailty: Frailty, common among older adults, is marked by weight loss, fatigue, malnutrition, and general weakness. A 2022 review linked high frailty to lower long-term survival outcomes for ovarian cancer. Ioffe says frailty may have an impact on your survival rate because it can affect how well you handle surgery.
  • History of smoking: A 2017 study of people with ovarian cancer in Canada linked cigarette smoking to a 25% increased risk of death from ovarian cancer.
  • Higher body mass index (BMI): The link between BMI and survival rates for ovarian cancer remains unclear. Authors of the 2017 study linked a higher BMI 5 years pre-diagnosis to worse survival outcomes. But in another study from 2017, researchers found that BMI had a varying impact on survival rates: A BMI of 35 or over appeared to improve chances of survival for people with late-stage ovarian cancer.

“Stage 4 ovarian cancer is complicated, and treatment must be tailored to each individual person,” Bertucio says.

According to Bertucio, stage 4 ovarian cancer treatment usually involves a combination of:

  • Surgery: Your care team may recommend removing your ovaries, fallopian tubes, uterus, and nearby lymph nodes. The goal of surgery is to get rid of as much of the cancer as possible.
  • Chemotherapy: This treatment uses drugs to attack cancer cells and prevent tumors from growing.
  • Targeted therapy: This approach uses drugs and other substances to pinpoint specific weaknesses in cancer cells to prevent the cancer from spreading.

In some cases, your doctor may recommend chemotherapy before surgery to shrink a large tumor before removing it, Outler says.

The decision about whether to continue treatment is a highly personal one that only you can make, though you may choose to enlist support from your doctor and loved ones.

If you reach a point where treatments no longer seem to help, or you choose not to continue with treatment for any reason, remember you’re not alone in figuring out next steps, such as palliative care and hospice care.

  • Palliative care focuses on managing your symptoms rather than curing or treating the cancer. According to Outler, pursuing palliative care as soon as possible after your diagnosis can help you regain a sense of control.
  • Hospice care aims to minimize your pain and discomfort and improve your quality of life. You may opt to receive this type of palliative care at home or a long-term hospice care center.

Along with your doctor and other treatment professionals, your care team might also include a social worker, psychologist or counselor, and chaplain or spiritual advisor.

Your care team can always offer more information about your options, based on your specific needs — whether those include emotional support, rides to appointments, or help with pain management.

“I generally recommend that anyone with late-stage cancer consider planning for hospice or palliative care earlier than later,” Bertucio says.

Insurance often covers palliative care, so it’s always worth getting more information about your options. Working with a palliative care team while receiving treatment can help ensure you have ample support ready, if your situation changes.

“The key is to plan for all long-term possibilities while maintaining a positive outlook,” Ioffe says.


The ACS offers a range of programs and services to help you during and after cancer treatments.

These services include:

  • transportation assistance
  • a helpline for getting guidance or sharing your concerns
  • help connecting you with other cancer survivors
  • help with lodging expenses when treatment requires traveling
Was this helpful?

The outlook for stage 4 ovarian cancer can depend on a range of different factors, from your age and overall health to which treatment you receive and how you respond to it.

Treatment usually includes a combination of surgery and chemotherapy, and your doctor can determine the best options for you based on your health condition and specific circumstances.

If you feel overwhelmed with a mix of emotions after your diagnosis, remember: You’re not alone.

Your doctor, therapist, and palliative care team can answer your questions and provide additional guidance and support as you navigate the next stages of treatment and care.

Rebecca Strong is a Boston-based freelance writer covering health and wellness, fitness, food, lifestyle, and beauty. Her work has also appeared in Insider, Bustle, StyleCaster, Eat This Not That, AskMen, and Elite Daily.