Prognostic Factors in Stage IV Ovarian Carcinoma Treated with Platinum-Based Regimens

Abstract

Eight factors were analyzed for prognostic significance in univariate analyses in a series of 76 women with stage IV ovarian carcinoma treated with combination chemotherapies including cisplatin or carboplatin. The clinical objective and pathologic complete response rates were 51.2% and 27.3%, respectively. Median overall survival and progression-free survival were 15 and 7 months, respectively. No variables reached statistical significance. Trends toward better survival were noted for grades 1 and 2 for the adriamycin-containing regimen. Using progression-free survival as an end point, significant prognostic factors included complete clinical or pathologic response. Our data confirm that the standard approach is unlikely to modify the clinical outcome of stage IV ovarian cancer. New treatment modalities including high-dose-intensity regimens and neo-adjuvant chemotherapy delivered before surgery could improve clinical results. Moreover, biologic characterization of ovarian tumors may provide information to design specifically targeted treatment.

Impact of residual disease on overall survival in women with Federation of Gynecology and Obstetrics stage IIIB‐IIIC vs stage IV epithelial ovarian cancer after primary surgery

“…abdomen or lower abdomen vs both) in stage IIIB-IIIC disease was associated with poor OS.Few studies have investigated the impact of residual disease after primary debulking surgery on OS in women diagnosed with stage IV EOC. Smaller series have been published on stage IV disease [6][7][8][9][10]15. In line with previous studies 11,14 our results confirm that residual disease = 0 after primary debulking surgery is one of the most powerful determinants of OS in stage IV disease.…”

“…Smaller series have been published on stage IV disease. [6][7][8][9][10]15 Recently, the first larger study on the influence of residual disease on outcomes in 573 women with stage IV EOC was published. They found that residual disease = 0 was associated with a significantly improved outcome.…”

“…[6][7][8][9][10][11][12] In the period 2013-2016 71% of women with stage IIIC-IV disease who underwent primary debulking surgery in Denmark obtained residual disease = 0. [6][7][8][9][10][11][12] In the period 2013-2016 71% of women with stage IIIC-IV disease who underwent primary debulking surgery in Denmark obtained residual disease = 0.…”

“…Studies conducted on the prognostic impact of intra-abdominal residual disease in stage IV EOC show there is an increase in OS if residual disease = 0 is obtained, but large prospective populationbased studies are missing. [6][7][8][9][10][11][12] In the period 2013-2016 71% of women with stage IIIC-IV disease who underwent primary debulking surgery in Denmark obtained residual disease = 0. 1 To date no diagnostic tool that predicts the level of cytoreduction with certainty exists.…”