The time interval from surgery to start of chemotherapy significantly impacts prognosis in patients with advanced serous ovarian carcinoma — Analysis of patient data in the prospective OVCAD study |
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| Authors: | G Hofstetter N Concin I Braicu R Chekerov J Sehouli I Cadron T Van Gorp F Trillsch S Mahner H Ulmer C Grimm D Cacsire Castillo-Tong R Zeillinger AG Zeimet I Vergote |
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| Institution: | 1. Department of Gynecology and Obstetrics, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria;2. Department of Gynecology, European Competence Center for Ovarian Cancer, Campus Virchow Klinikum, Charité — Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany;3. Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology and Leuven Cancer Institute, Universitaire Ziekenhuzen Leuven, Katholieke Universiteit Leuven, Herestraat 49, 3000 Leuven, The Netherlands;4. Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, MUMC +, GROW — School for Oncology and Developmental Biology, PO Box 5800, 6202AZ Maastricht, The Netherlands;5. Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany;6. Department of Medical Statistics, Informatics and Health Economics, Innsbruck Medical University, Schoepfstrasse 41, 6020 Innsbruck, Austria;g Department of Obstetrics and Gynecology, Molecular Oncology Group, Medical University of Vienna, Waehringer Guertel 18–20, 5Q, 1090 Vienna, Austria;h Ludwig Boltzmann Cluster Translational Oncology, General Hospital of Vienna, Waehringer Guertel 18–20, 5Q, 1090 Vienna, Austria |
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| Abstract: | ObjectiveCytoreductive surgery and platinum-based systemic therapy constitute the standard treatment of patients with advanced ovarian cancer. The aim of the present study was to evaluate whether the time interval from surgery to start of chemotherapy has an impact on clinical outcome.MethodsData of 191 patients with advanced serous (FIGO III–IV) ovarian cancer from the prospective multicenter study OVCAD (OVarian CAncer Diagnosis) were analyzed. All patients underwent primary surgery followed by platinum-based chemotherapy.ResultsThe 25%, 50%, and 75% quartiles of intervals from surgery to start of chemotherapy were 22, 28, and 38 days, respectively (range, 4–158 days). Preoperative performance status (P < 0.001), extent of surgery (P < 0.001), and perioperative complications (P < 0.001) correlated with intervals from surgery to initiation of chemotherapy. Timing of cytotoxic treatment ≤ 28 days versus > 28 days; hazard ratio (HR) 1.73 (95% confidence interval 1.08–2.78), P = 0.022], residual disease HR 2.95 (95% confidence interval 1.87–4.67), P < 0.001], and FIGO stage HR 2.26 (95% confidence interval 1.41–3.64), P = 0.001] were significant prognostic factors for overall survival in multivariate analysis. While the interval from surgery to start of chemotherapy did not possess prognostic significance in patients without postoperative residual disease (n = 121), it significantly correlated with overall survival in patients with postoperative residual disease n = 70, HR 2.24 (95% confidence interval 1.08–4.66), P = 0.031].ConclusionOur findings suggest that delayed initiation of chemotherapy might compromise overall survival in patients with advanced serous ovarian cancer, especially when suboptimally debulked. |
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| Keywords: | Ovarian cancer Timing of chemotherapy Prognosis |
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