Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2022 Nov;129(Suppl 2):70-78.
doi: 10.1111/1471-0528.17329.

Does the primary treatment sequence affect post-relapse survival in recurrent epithelial ovarian cancer? A real-world multicentre retrospective study

Xingyu Liu  1   2 , Yingjun Zhao  1   2 , Xiaofei Jiao  1   2 , Yang Yu  1   2 , Ruyuan Li  3 , Shaoqing Zeng  1   2 , Jianhua Chi  1   2 , Guanchen Ma  1   2 , Yabing Huo  1   2 , Ming Li  1   2 , Zikun Peng  1   2 , Jiahao Liu  1   2 , Qi Zhou  4   5 , Dongling Zou  4   5 , Li Wang  6 , Qingshui Li  7 , Jing Wang  8   9 , Shuzhong Yao  10 , Youguo Chen  11 , Ding Ma  1   2 , Ting Hu  1   2 , Qinglei Gao  1   2
Affiliations
Multicenter Study

Does the primary treatment sequence affect post-relapse survival in recurrent epithelial ovarian cancer? A real-world multicentre retrospective study

Xingyu Liu et al. BJOG. 2022 Nov.

Abstract

Objective: To explore the impact of the primary treatment sequence (primary debulking surgery, PDS, versus neoadjuvant chemotherapy and interval debulking surgery, NACT-IDS) on post-relapse survival (PRS) and recurrence characteristics of recurrent epithelial ovarian cancer (REOC).

Design: Real-world retrospective study.

Setting: Tertiary hospitals in China.

Population: A total of 853 patients with REOC at International Federation of Gynaecology and Obstetrics stages IIIC-IV from September 2007 to June 2020. Overall, 377 and 476 patients received NACT-IDS and PDS, respectively.

Methods: Propensity score-based inverse probability of treatment weighting (IPTW) was performed to balance the between-group differences.

Main outcome measures: Clinicopathological factors related to PRS.

Results: The overall median PRS was 29.3 months (95% CI 27.0-31.5 months). Multivariate analysis before and after IPTW adjustment showed that NACT-IDS and residual R1/R2 disease were independent risk factors for PRS (p < 0.05). Patients with diffuse carcinomatosis and platinum-free interval (PFI) ≤ 12 months had a significantly worse PRS (p < 0.001). Logistic regression analysis revealed that NACT-IDS was an independent risk factor for diffuse carcinomatosis (OR 1.36, 95% CI 1.01-1.82, p = 0.040) and PFI ≤ 12 months (OR 1.59, 95% CI 1.08-2.35, p = 0.019). In IPTW analysis, NACT-IDS was still significantly associated with diffuse carcinomatosis (OR 1.29, 95% CI 1.05-1.58, p = 0.015) and PFI ≤ 12 months (OR 1.90, 95% CI 1.52-2.38, p < 0.001).

Conclusions: The primary treatment sequence may affect the PRS of patients with REOC by altering the recurrence pattern and PFI duration.

Keywords: advanced epithelial ovarian cancer; neoadjuvant chemotherapy; post-relapse survival; primary debulking surgery; recurrence pattern.

PubMed Disclaimer

References

REFERENCES

    1. Kehoe S, Hook J, Nankivell M, Jayson GC, Kitchener H, Lopes T, et al. Primary chemotherapy versus primary surgery for newly diagnosed advanced ovarian cancer (CHORUS): an open-label, randomised, controlled, non-inferiority trial. Lancet. 2015;386(9990):249-57.
    1. Redman CW, Warwick J, Luesley DM, Varma R, Lawton FG, Blackledge GR. Intervention debulking surgery in advanced epithelial ovarian cancer. Br J Obstet Gynaecol. 1994;101(2):142-6.
    1. Rose PG, Nerenstone S, Brady MF, Clarke-Pearson D, Olt G, Rubin SC, et al. Secondary surgical cytoreduction for advanced ovarian carcinoma. N Engl J Med. 2004;351(24):2489-97.
    1. van der Burg ME, van Lent M, Buyse M, Kobierska A, Colombo N, Favalli G, et al. The effect of debulking surgery after induction chemotherapy on the prognosis in advanced epithelial ovarian cancer. Gynecological cancer cooperative Group of the European Organization for research and treatment of cancer. N Engl J Med. 1995;332(10):629-34.
    1. Vergote I, Trope CG, Amant F, Kristensen GB, Ehlen T, Johnson N, et al. Neoadjuvant chemotherapy or primary surgery in stage IIIC or IV ovarian cancer. N Engl J Med. 2010;363(10):943-53.

Publication types

LinkOut - more resources