Synapse - Adjuvant chemotherapy in patients with stage I endometrioid or clear cell ovarian cancer in the platinum era: A Surveillance, Epidemiology, and End Results cohort study, 2000-2013

Adjuvant chemotherapy in patients with stage I endometrioid or clear cell ovarian cancer in the platinum era: A Surveillance, Epidemiology, and End Results cohort study, 2000-2013 Journal Article

Authors:	Oseledchyk, A.; Leitao, M. M. Jr; Konner, J.; O'Cearbhaill, R. E.; Zamarin, D.; Sonoda, Y.; Gardner, G. J.; Roche, K. L.; Aghajanian, C. A.; Grisham, R. N.; Brown, C. L.; Snyder, A.; Chi, D. S.; Soslow, R. A.; Abu-Rustum, N. R.; Zivanovic, O.
Article Title:	Adjuvant chemotherapy in patients with stage I endometrioid or clear cell ovarian cancer in the platinum era: A Surveillance, Epidemiology, and End Results cohort study, 2000-2013
Abstract:	Background: We sought to evaluate the impact of adjuvant chemotherapy on overall survival (OS) in patients with stage I endometrioid epithelial ovarian cancer (EEOC) or ovarian clear cell cancer (OCCC) using a national database. Patients and methods: The Surveillance, Epidemiology, and End Results database was used to identify patients diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage I EEOC or OCCC from 2000 to 2013. We sought to identify predictors of chemotherapy use and to assess the impact of chemotherapy on OS in these patients. OS was compared using the log-rank test and the Cox proportional hazards model. Results: In all, 3552 patients with FIGO stage I EEOC and 1995 patients with stage I OCCC were identified. Of the 1600 patients (45%) with EEOC who underwent adjuvant chemotherapy, the 5-year OS rate was 90%, compared with 89% for those who did not undergo adjuvant chemotherapy (P=0.807). Of the 1374 (69%) patients with OCCC who underwent adjuvant chemotherapy, the 5-year OS rate was 85%, compared with 83% (P=0.439) for those who did not undergo adjuvant chemotherapy. Chemotherapy use was associated with younger age, higher substage, and more recent year of diagnosis for both the EEOC and OCCC groups. Only in the subgroup of patients with FIGO substage IC, grade 3 EEOC (n=282) was chemotherapy associated with an improved 5-year OS-81% compared with 62% (P=0.003) in untreated patients (HR: 0.583; 95% CI: 0.359-0.949; P=0.030). In patients with OCCC, there was no significant effect of adjuvant chemotherapy on OS in any substage. Conclusions: Adjuvant chemotherapy was associated with improved OS only in patients with substage IC, grade 3 EEOC. In stage I OCCC, adjuvant chemotherapy was not associated with improved OS. © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.
Keywords:	ovarian cancer; adjuvant chemotherapy; stage i; seer; endometrioid ovarian cancer; ovarian clear cell cancer
Journal Title:	Annals of Oncology
Volume:	28
Issue:	12
ISSN:	0923-7534
Publisher:	Oxford University Press
Date Published:	2017-12-01
Start Page:	2985
End Page:	2993
Language:	English
DOI:	10.1093/annonc/mdx525
PROVIDER:	scopus
PUBMED:	28950307
PMCID:	PMC5834056
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85042149080&doi=10.1093%2fannonc%2fmdx525&partnerID=40&md5=cad28bf9c71c66534145dbd944cfd60f
Notes:	Article -- Export Date: 1 March 2018 -- Source: Scopus