Prognostic significance of the number of postoperative intraperitoneal chemotherapy cycles for patients with advanced epithelial ovarian cancer Journal Article

   

Authors:	Suidan, R. S.; Zhou, Q.; Iasonos, A.; O'Cearbhaill, R. E.; Chi, D. S.; Long Roche, K. C.; Tanner, E. J.; Denesopolis, J.; Barakat, R. R.; Zivanovic, O.
Article Title:	Prognostic significance of the number of postoperative intraperitoneal chemotherapy cycles for patients with advanced epithelial ovarian cancer
Abstract:	Objective Phase 3 trials have demonstrated a survival advantage for patients with optimally debulked epithelial ovarian cancer who received intravenous (IV) and intraperitoneal (IP) chemotherapy compared with IV therapy alone. This was despite a significant proportion of patients in the IV/IP arms not completing all 6 planned cycles. Our objective was to evaluate the prognostic significance of the number of IV/IP cycles administered. Methods/Materials Data were analyzed for all patients with stage III to IV epithelial ovarian cancer who underwent optimal primary cytoreduction followed by 1 or more cycles of IV/IP chemotherapy from January 2005 to July 2011 at our institution. A landmark analysis was performed to associate progression-free survival (PFS) and overall survival (OS) with the number of IV/IP cycles given. Results We identified 201 patients; 26 (13%) received 1 to 2 cycles of IV/IP chemotherapy, 41 (20%) received 3 to 4 cycles, and 134 (67%) received 5 to 6 cycles. The 5-year PFS for patients who received 1 to 2, 3 to 4, and 5 to 6 cycles was 18%, 29%, and 17%, respectively. The 5-year OS for patients who received 1 to 2, 3 to 4, and 5 to 6 cycles was 44%, 54%, and 57%, respectively. There was no significant difference in PFS (P = 0.31) or OS (P = 0.14) between the 3 groups. The most common reason for discontinuing IV/IP therapy was treatment-related toxicity (77%). Postoperative complications were the most common reason for not initiating IV/IP therapy (42%) in patients who subsequently transitioned to it. Conclusions We did not detect a significant survival difference between patients who received 1 to 2, 3 to 4, or 5 to 6 IV/IP chemotherapy cycles. Women may still derive a survival benefit if they receive fewer than 6 IV/IP cycles. © 2015 by IGCS and ESGO.
Keywords:	adult; cancer survival; aged; major clinical study; overall survival; bevacizumab; cisplatin; advanced cancer; area under the curve; cancer combination chemotherapy; drug withdrawal; paclitaxel; postoperative care; cancer staging; ovarian cancer; cytoreductive surgery; carboplatin; progression free survival; multiple cycle treatment; gastrointestinal symptom; kidney disease; neuropathy; dehydration; medical record review; abdominal pain; drug hypersensitivity; postoperative complication; heart infarction; ovary carcinoma; ca 125 antigen; intestine obstruction; hematoma; wound infection; metabolic disorder; intraperitoneal chemotherapy; anastomosis leakage; progression-free survival; catheter complication; cancer prognosis; human; female; priority journal; article; cystovaginal fistula
Journal Title:	International Journal of Gynecological Cancer
Volume:	25
Issue:	4
ISSN:	1048-891X
Publisher:	Lippincott Williams & Wilkins
Date Published:	2015-05-01
Start Page:	599
End Page:	606
Language:	English
DOI:	10.1097/igc.0000000000000389
PROVIDER:	scopus
PMCID:	PMC4408230
PUBMED:	25664437
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84928888204&partnerID=40&md5=364704d722561c5f2d8fb7e2180d8371
Notes:	Export Date: 3 June 2015 -- Source: Scopus

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