Impact of neoadjuvant chemotherapy cycles on survival of patients with advanced ovarian cancer: A French national multicenter study (FRANCOGYN).
Aged
Antineoplastic Agents
/ therapeutic use
Cytoreduction Surgical Procedures
/ mortality
Female
France
Humans
Middle Aged
Neoadjuvant Therapy
/ methods
Ovarian Neoplasms
/ drug therapy
Ovary
/ surgery
Prognosis
Progression-Free Survival
Proportional Hazards Models
Retrospective Studies
Survival Rate
Time Factors
Treatment Outcome
Cytoreductive surgery
Neoadjuvant chemotherapy
Ovarian cancer
Surgical complications
Survival
Journal
European journal of obstetrics, gynecology, and reproductive biology
ISSN: 1872-7654
Titre abrégé: Eur J Obstet Gynecol Reprod Biol
Pays: Ireland
ID NLM: 0375672
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
received:
03
10
2019
revised:
03
12
2019
accepted:
04
12
2019
pubmed:
22
12
2019
medline:
1
12
2020
entrez:
22
12
2019
Statut:
ppublish
Résumé
The purpose of this study was to compare two groups of patients presenting advanced ovarian carcinoma benefiting from neoadjuvant chemotherapy (NAC) followed by cytoreductive surgery: after 3-4 cycles (group 1) or ≥ 5 cycles (group 2), regarding overall survival (OS) and progression-free survival (PFS), complications related to surgery as well as the extent of cytoreduction were assessed. We conducted a retrospective, multicenter cohort study in nine referral centers of France, reviewing the charts of all patients who underwent NAC between January 2000 and June 2017. We performed an OS analysis using multivariate Cox regression models adjusted for potential confounders. We also analyzed PFS and surgery-related morbidity. Of 501 patients included, 236 (47.1 %) benefited from ≤ 4 NAC cycles and 265 (52.9 %) from ≥ 5 NAC cycles. Characteristics data were similar in both groups. The rate of achievement of complete surgery was similar in both groups (p = 0.28). Surgical morbidity and postoperative complications showed no significant differences between both groups. The median OS was 54.2 months, 64 months for group 1 and 49.2 months for group 2. The 5-year survival rate was 45.6 % and 27.6 %. This difference was not statistically significant [HR 1.81 (0.89-3.71), p = 0.09]. Five-year PFS was 19.7 % and 11.7 % respectively (p = 0.31). In a large series of advanced ovarian cancer, patients receiving late IDS (≥ 5 NAC cycles) seem to show a poorer prognosis than patients operated on earlier. The survival appears to be mainly determined by optimal resection and response to chemotherapy.
Identifiants
pubmed: 31864157
pii: S0301-2115(19)30551-2
doi: 10.1016/j.ejogrb.2019.12.001
pii:
doi:
Substances chimiques
Antineoplastic Agents
0
Types de publication
Evaluation Study
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
64-72Informations de copyright
Copyright © 2019 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.