Abstract
ObjectiveThe aim of the present study was to investigate the prognostic role of the duration of adjuvant chemotherapy in patients with epithelial ovarian, fallopian tube and primary peritoneal cancer (EOC).Materials and MethodsWithin the present study we retrospectively evaluated the data of 165 consecutive patients with EOC treated with primary surgery followed by six completed cycles of platinum-taxan based intravenous adjuvant chemotherapy. Medians of total duration of chemotherapy were compared with clinical-pathological parameters. Patients were stratified into four risk groups according to the delay in days of total duration of chemotherapy, and univariate and multivariable survival analyses were performed.ResultsThe median duration of six completed cycles of chemotherapy comprised 113 days (IQR 107–124 days). Uni- and multivariable survival analyses revealed a delay of total duration of chemotherapy of at least 9 days to be associated with progression-free (PFS), cancer-specific (CSS) and overall survival (OS). Hazard ratios (HR), confidence intervals (95% CI) and p-values for PFS, CSS and OS due to delay of chemo-duration were 2.9 (1.6–5.4; p = 0.001), 2.9 (1.3–6.2; p = 0.008) and 2.6 (1.3–5.4; p = 0.008), respectively.Prolonged total chemo-duration was associated with the amount of postoperative residual disease (p = 0.001) and the patients’ age (p = 0.03).ConclusionThe present study suggests a prolonged duration of adjuvant chemotherapy after primary surgery to adversely affect PFS, CSS and OS in patients with EOC. Yet larger studies are required to validate our results.
Highlights
Epithelial ovarian cancer (EOC) is the second most common gynecological cancer, and, in 2012, was accountable for the deaths of 151.917 women worldwide [1]
Uni- and multivariable survival analyses revealed a delay of total duration of chemotherapy of at least 9 days to be associated with progression-free (PFS), cancer-specific (CSS) and overall survival (OS)
The present study suggests a prolonged duration of adjuvant chemotherapy after primary surgery to adversely affect progression-free survival (PFS), CSS and OS in patients with EOC
Summary
Epithelial ovarian cancer (EOC) is the second most common gynecological cancer, and, in 2012, was accountable for the deaths of 151.917 women worldwide [1]. As EOC causes few symptoms in its early stage, in approximately 75% of the patients disease has spread throughout the peritoneal cavity already at the time of diagnosis. Therapeutic success is dependent on two essential pillars: the achievement of optimal cytoreductive surgery (CRS) and the response to adjuvant chemotherapy [2]. Over the past decades the combination of a platinum and taxan based regimen has proved best response rates [3, 4]. Even after optimal CRS and complete response to adjuvant chemotherapy approximately two thirds of the patients experience progression of disease within 18 to 24 months [3]
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