Use and duration of chemotherapy and its impact on survival in early-stage ovarian cancer

Abstract

Objective-Although 5-year survival for early-stage ovarian cancer is favorable, prognosis at recurrence is poor, necessitating appropriate initial management. We examined the patterns of care and the impact of the duration of chemotherapy on survival for women with early-stage ovarian cancer.Methods-We used the SEER-Medicare database to identify women ≥65 years of age with stage I ovarian cancer diagnosed from 1992-2009. Patients were categorized as low-risk (non-clear cell histology, stage IA or IB, grade 1 or 2) or high-risk (clear cell histology, grade 3, or stage IC). We used multivariable logistic regression models to determine predictors of chemotherapy use and duration and Cox proportional hazards models to evaluate the effect of chemotherapy use and duration on survival.Results-We identified 1394 patients. Among low-risk patients, 32.9% received adjuvant chemotherapy and the use of chemotherapy increased with time. Among high-risk patients, 71.9% received adjuvant chemotherapy; 44.2% had ≤ 3 months of treatment, and 55.8% had >3 months of treatment. Older patients were less likely to receive chemotherapy, while those with higher Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. HHS Public Access

Adjuvant chemotherapy is not associated with improved overall survival with stage I endometrioid ovarian cancer patients in a SEER cohort

“…Our results confirmed that chemotherapy did not significantly improve the survival of patients with grade I IA and IB (p = 0.452, HR: 1.547, 95% CI: (0.497-4.815) (Tables 3,4, Fig. 3A), which was consistent with the NCCN Guidelines and previous literature [10,[12][13][14][15].…”

Quality of life among ovarian cancer survivors in Haji Adam Malik General Hospital Medan, Indonesia

“…This is because the duration of chemotherapy does not always determine the number of chemotherapy cycles a patient undergoes, so it cannot be used as a determinant of the type of therapy that the previous survivor received. 9 However, in this study there is a significant association between type of therapy and quality of life in ovarian cancer survivors. Compared to Bughwandass, the types of therapy underwent by the survivors affect their quality of life.…”

“…This could affect their attitude to the disease and its treatment. 9 The results obtained for the symptom scale in table 4 also have a fairly low average score (16.91) which shows that the level of symptoms or problems experienced by survivors based on EORTC QLQ OV-28 is not too problematic. This can be seen in abdominal/GI symptoms, other chemotherapy side effects, and hair loss showing very low scores which proves that most survivors no longer experience these complaints that may be experienced during therapy.…”

Clinical factors associated with prognosis in low-grade serous ovarian carcinoma: experiences at two large academic institutions in Korea and Taiwan

“…A randomized GOG trial comparing three versus six cycles of adjuvant chemotherapy showed no survival benefit for extended chemotherapy despite this strategy being accompanied by increased toxicity 31 . The study conducted by Dinkelspiel et al also reported that extended chemotherapy does not affect survival in the early stage with high risk (HR 0.93, 95% CI 0.67-1.27) 32 . Among 19 patients with FIGO stage IC in our study cohort, 18 had adjuvant chemotherapy and only one did not receive adjuvant treatment.…”