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Abstract
Introduction/Background Prognosis of advanced High grade Epithelial Ovarian cancer (HGSOC) depends on multitude of factors including patient factors, disease biology and surgical intervention. Present study aims to corelate survival of patients based on Chemotherapy response score (CRS).
Methodology Retrospective study approved by the Institutional Ethics Board conducted at Dr B Borooah cancer Institute, Guwahati, India from January 2018 to December 2019. Study included HGSOC patients with stages IIIC onwards, who underwent Interval Cytoreduction. CRS calculated based on tumor burden in postoperative histopathology. Survival outcomes noted, and statistically analysed with univariate and multivariate analysis.
Results 103 patients were analysed for Chemoresponse in the resected specimens, Ovary, Omentum and Peritoneal deposits CRS 3 (complete response) was demonstrated in 10% patients in all three sites (12% in Ovary only and 29% in Omentum only). Early recurrence rate (<10month) was significantly higher in women with residual disease in Omentum (CRS 1&2 ) ((OR 6.2, 95% CI 1.08–16.58, p=0.002) compared to disease in Peritoneum(OR 4.297, 95% CI 1.042 -5.063 p=0.038) and Ovary (OR 3.268, 95% CI 0.107 - 4.674, p= 0.005). On analysing predictors of post recurrence survival on cox regression analysis the risk of death post recurrence was highest in women with presence of disease in omentum post NACT (CRS 1&2) ( HR 2.3 95% CI 0.7–7.7, P=0.155) however, presence of disease in the ovary post NACT (CRS 1&2 ) had the least risk of death with hazard ratio (HR 0.488, CI 0.261 -0.913, p=0.025).
Conclusion Our study showed that omental CRS represents a possible surrogate for prediction of early relapses. Presence of disease in Ovary post NACT did not affect survival, compared to presence of disease in Omentum which showed poor outcome with worse prognosis.
Kaplan-Meier Survival analysis :Recurrence to Survival time in CRS Omentum
Disclosures None to declare.