Does time interval between surgery and intraperitoneal chemotherapy administration in advanced ovarian cancer carry a prognostic impact? An NRG Oncology/Gynecologic Oncology Group study ancillary study

Arlene E Garcia-Soto,James J Java,Wilberto Nieves Neira,J Matthew Pearson,David E Cohn,Shashikant B Lele,Krishnansu S Tewari,Joan L Walker,Angeles Alvarez Secord,Deborah K Armstrong,Larry J Copeland

doi:10.1016/j.ygyno.2016.10.003

Abstract

ObjectivesTo determine the relationship of the time from surgery to intraperitoneal (IP) chemotherapy (TSIC) initiation with survival of patients with stage III epithelial ovarian cancer (EOC) patients using ancillary data from cooperative group clinical trials. MethodsData from 420 patients with stage III EOC treated with IP chemotherapy under GOG-0114 and 172 were reviewed. The Cox proportional hazards model was used to evaluate independent prognostic factors and estimate their covariate-adjusted effects on PFS and OS. ResultsThe median TSIC was 62.5days (interquartile range 28–83). The median TSIC was longer for patients in GOG-0114 vs those in GOG-172 (83 vs 26days, p<0.001). TSIC was significantly associated (p=0.049) with PFS: each 10% increase in TSIC (days) decreases the risk of progression by 3%. TSIC was not significantly associated with OS in this model. In a linear regression model, gross residual disease was significantly associated with shorter TSIC (R2 −0.141, 95%CI −0.217, −0.064, p<0.001). When only data from GOG-172 were considered, no statistical significant association was found between TSIC and PFS or OS. ConclusionsIn this ancillary data study, TSIC was not associated with improved OS in patients with stage III epithelial ovarian cancer. TSIC was significantly associated with PFS for the entire cohort, suggesting increase in PFS with longer TSIC. However, this was not found when only data from GOG 172 or GOG 114 were analyzed separately. Hence, the relationship between IP chemotherapy initiation and time from surgery needs to be studied further.

Highlights

Ovarian carcinoma is the leading cause of death from gynecological malignancy in the United States [1]
A retrospective review of data collected from patients with epithelial ovarian cancer (EOC) treated with IP chemotherapy on randomized clinical trials conducted by the GOG, protocols 114 [15] and 172 [2], was performed
Data from 420 patients enrolled in the IP arm of GOG-0114 (n = 220) and 172 (n = 200) with complete to of first-line IP chemotherapy initiation (TSIC) values were included in this study

Summary

Introduction

Ovarian carcinoma is the leading cause of death from gynecological malignancy in the United States [1]. Advances in survival have been achieved, with the one of the longest median survival reported to date at 66 months for stage III epithelial ovarian cancer (EOC) patients treated with intraperitoneal (IP) chemotherapy [2]. Even though there is high overall clinical response rates achieved with platinumbased therapy (up to 80%), b30% of patients will remain free of disease [3]

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Methods

Results