Introduction/Background*Despite the majority of ovarian carcinoma patients (OvCa) initially responding to primary therapy, relapse occurs frequently in early and advanced stages (25 and 80% respectively) and OvCa is still associated with an overall poor prognosis. Nevertheless, therapy response and disease progression can be quite variable and long-term survival is reported in up to 30% of patients. It is known that, even after multiple chemotherapy lines, platinum sensitivity is associate with a longer therapy-free interval. The aim of this study was to investigate platinum resistance in long-term OvCa survivors.
Methodology Patients diagnosed with OvCa at the Tuebingen University Women’s Hospital between 2000 and 2012 were retrospectively identified and follow-up data was collected. For patients surviving at least 8 years a detailed chart review was performed. Platinum resistance was defined as disease progression during platinum-based chemotherapy or 6 months after the last platinum dose administration.
Result(s)*From a total n=745 of patients with adequate follow-up data, n=223(30%) survived at least 8 years after primary diagnosis. Median follow-up was 12.1 years and median age at diagnosis was 54.7 years. Relapse was recorded in 87/223(39%) patients, of which 28/87(32%) developed platinum resistance at some point. Platinum resistance was observed after the second line chemotherapy in most patients (median: 2, range: 1–4). 23/28 patients received further chemotherapy lines (median: 2, range: 0–8). Rechallenge with a platinum-based chemotherapy has been used in 9/28(32%) patients. Median overall survival of these 28 patients was 9.3 years (8.2–18.4, IQR3.7) and 4.1 (0.4–16.8, IQR3.8) years after platinum resistance.
Conclusion*We were able to demonstrate long-term survival after platinum resistance in a substantial number of ovarian carcinoma patients. Suggesting therefore, that other parameters influence the disease behaviour. Further research of patient characteristics, environmental and genetic features and treatment modalities will help to further understand factors contributing to long-term survival.
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