Chemotherapeutic Regimens and Chemotherapy-Free Intervals Influence the Survival of Patients with Recurrent Advanced Epithelial Ovarian Carcinoma: A Retrospective Population-Based Study.

Hsin-Ying Huang,Wen-Fang Cheng,Yun-Yuan Chen,San-Lin You,Chun-Ju Chiang,Heng-Cheng Hsu,Chao-Hsiun Tang

doi:10.3390/ijerph18126629

Abstract

We aimed to evaluate factors influencing the outcomes of patients with platinum-sensitive recurrent epithelial ovarian carcinoma (EOC). Patients with advanced-stage EOC, who received debulking surgery and adjuvant chemotherapy for recurrence, were obtained from the National Health Insurance Research database of Taiwan between 2000 and 2013. A total of 1038 patients with recurrent advanced-stage EOC were recruited. The platinum + paclitaxel (PT) group had the best five-year overall survival (OS) compared with the other three groups (p < 0.001). The hazard ratios (HRs) of five-year OS for the platinum + liposomal doxorubicin (PD), topotecan (TOP), and pegylated liposomal doxorubicin (PLD) groups were 1.21 (p = 0.07), 1.35 (p = 0.016), and 1.80 (p < 0.001), respectively, compared with the PT group. The PT group also had lower hazard ratios of five-year OS for patients with platinum therapy-free interval (TFIp) between 6 and 12 months compared with the other three groups (p < 0.0001). However, the HRs of five-year OS did not differ between the PT and PD groups in patients with TFIp >12 months. Patients with TFIp >12 months had lower HRs of five-year OS compared with those with TFIp of 6–12 months, regardless of whether they were treated with platinum-based (p = 0.001) or non-platinum-based (p = 0.003) regimens. Chemotherapeutic regimens and TFIp influenced the outcomes of patients with recurrent EOC. For patients with TFIp of 6–12 months, the PT regimen is the first choice based on their best overall survival result. For patients with TFIp >12 months, either platinum-based or non-platinum regimens could be used because of their similar excellent overall survival.

Highlights

According to global research and statistics, epithelial ovarian carcinoma (EOC) is the seventh most common cancer in women and the eighth most common cause ofInt
EOC who were administered the following four major chemotherapy regimens, as recommended by clinical guidelines in Taiwan [21], including platinum analogues combined with paclitaxel, platinum analogues combined with liposomal doxorubicin, topotecan alone, and liposomal doxorubicin alone for the first chemotherapy treatment after cancer recurrence
A total of 1038 patients with recurrent advanced EOC, including 605 who received platinum analogues combined with a paclitaxel regimen (PT group), 204 who received platinum analogues combined with and pegylated liposomal doxorubicin (PD group),109 who received TOP alone, and 120 who received pegylated liposomal doxorubicin (PLD)

Summary

Introduction

According to global research and statistics, epithelial ovarian carcinoma (EOC) is the seventh most common cancer in women and the eighth most common cause ofInt. According to global research and statistics, epithelial ovarian carcinoma (EOC) is the seventh most common cancer in women and the eighth most common cause of. Res. Public Health 2021, 18, 6629 cancer-related deaths, with five-year survival rates below 45% worldwide [1]. The global age-standardized rate (ASR) of ovarian cancer is highest in Central/Eastern Europe (11.9/100,000), followed by Northern Europe (9.2/100,000), North America (8.4/100,000), Western Europe (7.0/100,000), Australia (6.9/100,000), and Middle Africa (3.8/100,000) [2]

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