Prognostic Significance of the Number of Postoperative Intraperitoneal Chemotherapy Cycles for Patients With Advanced Epithelial Ovarian Cancer. Issue 4 (1st May 2015)

• Record Type: Journal Article
• Authors: Suidan, Rudy S.; Zhou, Qin; Iasonos, Alexia; O'Cearbhaill, Roisin E.; Chi, Dennis S.; Long Roche, Kara C.; Tanner, Edward J.; Denesopolis, John; Barakat, Richard R.; Zivanovic, Oliver
• Is Part Of: International journal of gynecological cancer. Volume 25:Issue 4(2015:May)
• Page Start: 599
• Page End: 606
• Publication Date: 2015-05-01
• Subjects: Ovarian cancer -- Intraperitoneal chemotherapy -- Progression-free survival -- Overall survival; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1097/IGC.0000000000000389
• Languages: English
• ISSNs: 1048-891X

Abstract

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.