Abstract
Purpose: A 2006 National Cancer Institute clinical announcement recommended the use of combined intravenous (IV) and intraperitoneal (IP) chemotherapy over IV chemotherapy alone for women with International Federation of Gynecology and Obstetrics (FIGO) stage 3 optimally debulked ovarian cancer due to significant survival benefit demonstrated in multiple randomized clinical trials. We examined uptake of IP chemotherapy in community practice before and after this recommendation.Methods: We identified 288 women with FIGO stage 2 or greater incident ovarian cancer diagnosed from 2003 to 2008 at three integrated delivery systems in the US. Administrative health plan data were used to determine patient characteristics and receipt of IV and IP chemotherapy within 12 months of diagnosis. We compared characteristics of women receiving IV chemotherapy alone vs. IP chemotherapy (with or without IV chemotherapy) and assessed temporal trends in IP chemotherapy use.Results: Overall 12.5% (n = 36) of women received IP chemotherapy during the study period. IP chemotherapy use was non-existent between 2003 and 2005. Use of IP chemotherapy occurred among 26.9% of women diagnosed in 2006 and plateaued at 20.4% of women diagnosed in 2008. IP recipients were younger (mean age 55.9 vs. 63.5 years, p = < 0.001) and more likely to have stage 3 ovarian cancer (77.8 vs. 50.4% p = 0.039) compared to their IV-only chemotherapy counterparts.Conclusion: Use of IP chemotherapy for newly diagnosed advanced stage ovarian cancer patients was uncommon in this community setting. Future research should identify potential patient, physician, and system barriers and facilitators to using IP chemotherapy in this setting.
Highlights
22,280 new ovarian cancers were diagnosed in 2012, and an estimated 15,500 women died from the disease [1]
Use of IP chemotherapy for newly diagnosed advanced stage ovarian cancer patients was uncommon in this community setting
A total of 288 women were identified with Federation of Gynecology and Obstetrics (FIGO) stage 2 or greater incident ovarian cancer between 2003 and 2008
Summary
22,280 new ovarian cancers were diagnosed in 2012, and an estimated 15,500 women died from the disease [1]. While ovarian cancer is uncommon, long-term cure is poor with an overall 5-year survival rate of 43.7% [1]. Prior to 2006, women with late-stage ovarian cancer were treated primarily with intravenous (IV) chemotherapy, which generally included a combination of platinum and taxane given every 3 weeks for six courses [2]. This treatment has resulted in only a 26.9% 5-year survival rate when prognosis is grim [1]. The announcement was based on national randomized trial data with 415 women with stage 3 ovarian cancer and
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