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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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. / Hofstetter, G; Concin, N; Braicu, I; Chekerov, R; Sehouli, J; Cadron, I; Van Gorp, T; Trillsch, F; Mahner, S; Ulmer, H; Grimm, C; Castillo-Tong, D Cacsire; Zeillinger, R; Zeimet, A G; Vergote, I.
In: GYNECOL ONCOL, Vol. 131, No. 1, 01.10.2013, p. 15-20.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - 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
AU - Hofstetter, G
AU - Concin, N
AU - Braicu, I
AU - Chekerov, R
AU - Sehouli, J
AU - Cadron, I
AU - Van Gorp, T
AU - Trillsch, F
AU - Mahner, S
AU - Ulmer, H
AU - Grimm, C
AU - Castillo-Tong, D Cacsire
AU - Zeillinger, R
AU - Zeimet, A G
AU - Vergote, I
N1 - © 2013.
PY - 2013/10/1
Y1 - 2013/10/1
N2 - OBJECTIVE: Cytoreductive 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.METHODS: Data 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.RESULTS: The 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].CONCLUSION: Our findings suggest that delayed initiation of chemotherapy might compromise overall survival in patients with advanced serous ovarian cancer, especially when suboptimally debulked.
AB - OBJECTIVE: Cytoreductive 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.METHODS: Data 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.RESULTS: The 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].CONCLUSION: Our findings suggest that delayed initiation of chemotherapy might compromise overall survival in patients with advanced serous ovarian cancer, especially when suboptimally debulked.
KW - Antineoplastic Combined Chemotherapy Protocols
KW - Carcinoma
KW - Disease-Free Survival
KW - Female
KW - Humans
KW - Kaplan-Meier Estimate
KW - Middle Aged
KW - Neoplasm Staging
KW - Neoplasm, Residual
KW - Ovarian Neoplasms
KW - Proportional Hazards Models
KW - Survival Rate
KW - Time Factors
KW - Time-to-Treatment
U2 - 10.1016/j.ygyno.2013.07.086
DO - 10.1016/j.ygyno.2013.07.086
M3 - SCORING: Journal article
C2 - 23877013
VL - 131
SP - 15
EP - 20
JO - GYNECOL ONCOL
JF - GYNECOL ONCOL
SN - 0090-8258
IS - 1
ER -
