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Comparative Study
. 2017 Feb;144(2):274-278.
doi: 10.1016/j.ygyno.2016.12.004. Epub 2016 Dec 12.

Three versus six cycles of adjuvant platinum-based chemotherapy in early stage clear cell ovarian carcinoma - A multi-institutional cohort

Emily N Prendergast  1 , Marie Holzapfel  1 , Jennifer J Mueller  2 , Mario M Leitao Jr  2 , Camille C Gunderson  3 , Kathleen N Moore  3 , Britt K Erickson  4 , Charles A Leath 3rd  4 , Elena S Diaz Moore  1 , Joshua G Cohen  5 , Christine S Walsh  6
Affiliations
Comparative Study

Three versus six cycles of adjuvant platinum-based chemotherapy in early stage clear cell ovarian carcinoma - A multi-institutional cohort

Emily N Prendergast et al. Gynecol Oncol. 2017 Feb.

Abstract

Objectives: To determine if 6 versus 3cycles of adjuvant platinum-based chemotherapy with or without taxane impacts survival in early stage ovarian clear cell carcinoma (OCCC).

Methods: We retrospectively identified all cases of stage I and II OCCC treated at 5 institutions from January 1994 through December 2011. Patients were divided into 2 groups: those who received 3 versus 6cycles of adjuvant chemotherapy. Our cohort consisted of 210 patients with stage IA-II disease, 116 of whom underwent full surgical staging. Cox proportional hazards regression and Kaplan-Meier analyses were performed to evaluate progression-free (PFS) and overall survival (OS) between groups.

Results: Among 210 eligible patients, the median age was 53years (range 30-88). The majority of patients were Caucasian (83.8%). All patients received adjuvant chemotherapy with 90% receiving carboplatin and paclitaxel. Thirty-eight (18.1%) patients received 3cycles, and 172 (81.9%) patients received 6cycles of adjuvant treatment. Recurrence rate was comparable between groups (18.4% vs. 27.3% for 3 vs. 6cycles, p=0.4). There was no impact of 3 versus 6cycles of chemotherapy on PFS (hazard ratio [HR] 1.4; 95% confidence interval [CI] 0.63-3.12, p=0.4) or OS (HR 1.65; 95% CI 0.59-4.65, p=0.3) on univariate analysis. There was no benefit to more chemotherapy in stratified analysis by stage nor on multivariate analysis adjusting for the impact of stage. Subgroup analysis of surgically staged patients also showed no difference in survival between 3 versus 6cycles of chemotherapy.

Conclusions: Three cycles of platinum with or without taxane adjuvant chemotherapy were comparable to 6cycles with respect to recurrence and survival in patients diagnosed with early stage ovarian clear cell carcinoma in this retrospective multi-institutional cohort.

Condensation: Three cycles of platinum with or without taxane adjuvant chemotherapy are comparable to 6 cycles with respect to recurrence and survival in patients diagnosed with early stage ovarian clear cell carcinoma in this retrospective multi-institutional cohort.

Keywords: Chemotherapy; Clear cell; Early stage; Ovarian cancer; Survival.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
Kaplan-Meier estimation of (A) PFS and (B) OS among patients with stage I-II OCCC who completed 3 or 6 cycles of platinum-based chemotherapy (n=210; p=0.9 and p=0.3, respectively)
FIGURE 1
FIGURE 1
Kaplan-Meier estimation of (A) PFS and (B) OS among patients with stage I-II OCCC who completed 3 or 6 cycles of platinum-based chemotherapy (n=210; p=0.9 and p=0.3, respectively)
FIGURE 2
FIGURE 2
Kaplan-Meier estimation of (A) PFS and (B) OS among patients with stage IC OCCC who completed 3 or 6 cycles of platinum-based chemotherapy (n=98; p=0.6 and p=0.2, respectively)
FIGURE 2
FIGURE 2
Kaplan-Meier estimation of (A) PFS and (B) OS among patients with stage IC OCCC who completed 3 or 6 cycles of platinum-based chemotherapy (n=98; p=0.6 and p=0.2, respectively)
FIGURE 3
FIGURE 3
Kaplan-Meier estimation of (A) PFS and (B) OS among patients with fully-staged early stage OCCC who completed 3 or 6 cycles of platinum-based chemotherapy
FIGURE 3
FIGURE 3
Kaplan-Meier estimation of (A) PFS and (B) OS among patients with fully-staged early stage OCCC who completed 3 or 6 cycles of platinum-based chemotherapy
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