Outcomes of Non-High Grade Serous Carcinoma after Neoadjuvant Chemotherapy for Advanced-Stage Ovarian Cancer: Single-Institution Experience

Abstract

PurposeOutcomes in patients with ovarian high-grade serous carcinoma (HGSC) treated with neoadjuvant chemotherapy (NAC) have been widely studied; however, there is limited information on responses to chemotherapy among patients with non-HGSC. The aim of this study was to compare the survival outcomes of patients with advanced-stage non-HGSC and HGSC treated with NAC.Materials and MethodsThis study was a retrospective analysis of patients with advanced-stage ovarian cancer treated at Yonsei Cancer Hospital between 2006 and 2017. The demographics, chemotherapy response, and survival rates were compared between patients with non-HGSC and those with HGSC.ResultsAmong 220 patients who underwent NAC, 25 (11.4%) patients had non-HGSC histologic subtypes, and all received a taxane-platinum combination regimen for NAC. Patients with non-HGSC had lower baseline cancer antigen-125 levels (p<0.001), poorer response rates (p<0.001), lower rates of optimal cytoreduction (p=0.003), and poorer progression-free survival (PFS) (median PFS 10.3 months vs. 18.3 months; p=0.009) and overall survival (OS) (median OS 25.5 months vs. 60.6 months; p<0.001), compared to those with HGSC. In multivariate analysis, non-HGSC was a negative prognostic factor for both PFS [hazard ratio (HR), 3.19; 95% confidence interval (CI), 1.73–5.88] and OS (HR, 4.22; 95% CI, 2.07–8.58).ConclusionIn this study, poorer survival outcomes were observed in patients who underwent NAC for treatment of non-HGSC versus those treated for HGSC. Different treatment strategies are urgently required to improve survival outcomes for patients with non-HGSC undergoing NAC.

RETRACTED ARTICLE: CYPA promotes the progression and metastasis of serous ovarian cancer (SOC) in vitro and in vivo

“…Because of the large and increasing number of elderly patients without treatment and the large survival gap, the opportunities for further improvements in the care for elderly ovarian cancer patients [32]. In fact, the progression free survival for patients diagnosed with advanced stage SOC is less than 18 months [2]. Therefore, targeted therapy and immunotherapy show broad prospects in the treatment of advanced SOC.…”

“…Ovarian cancer (OC) is s the seventh most common cancer and a type of gynaecological malignancies, with high mortality in females [1][2][3]. The majority of ovarian cancers (nearly 90%) are originated from epithelial tissues [4,5].…”

Comparison between weekly versus 3-weekly paclitaxel in combination with carboplatin as neoadjuvant chemotherapy in advanced ovarian cancer

“…Recently, phase III trials have established neoadjuvant chemotherapy (NAC), followed by interval debulking surgery (IDS), as a valid alternative for advanced-disease patients whose expected morbidity from immediate surgical intervention is too high or optimal debulking is unlikely [2,3]. However, ovarian cancer continues to be one of the leading causes of cancer deaths, as 5-year survival rate has only improved slightly from 57.2% to 62.8% during the last 20 years in South Korea [4,5].…”