The interval from surgery to chemotherapy in the treatment of advanced epithelial ovarian carcinoma

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Abstract

Background

To study the effect of the interval between surgery and the start of chemotherapy in the treatment of patients with advanced ovarian cancer.

Methods

We stratified patients according to the start of platinum-based chemotherapy in group 1 (within 4 weeks from surgery), group 2 (between 4 and 8 weeks) and group 3 (between 8 and 12 weeks).

Results

Three hundred and ninty-four stage III ovarian cancer patients were analysed. In the multivariate analysis there were no differences in survival according to the interval between surgery and chemotherapy among the three groups. The independent prognostic variables were type of procedure (p=0.014), performance status (p=0.040) and post-chemotherapy CA-125 (p<0.0001).

Conclusions

The interval between surgery and chemotherapy does not affect outcome.

Introduction

Ovarian cancer has a poor prognosis, with a 5-year survival ranging from 10% to 30% for advanced stage disease (FIGO stages III and IV).1, 2 The conventional treatment for ovarian cancer is debulking surgery followed by platinum-based therapy.1

The interval between surgery and chemotherapy may be an important determinant of outcome.1, 3, 4 Patients who cannot receive chemotherapy within 6 weeks from surgery are often excluded from clinical trials. The aim of our study was to see if the interval from surgery to the beginning of platinum based chemotherapy was associated with a worse or better overall survival of patients with stage III ovarian cancer treated at a single cancer centre.

Section snippets

Material and methods

We reviewed our database of patients who had been managed through the ovarian cancer clinic. All patients were managed by one Medical Oncologist and the histopathology was reviewed in all cases by specialist histopathologists.

The interval from surgery to the beginning of chemotherapy was stratified in three groups: patients who received chemotherapy within 4 weeks of surgery (group 1), patients whose chemotherapy started between 4 and 8 weeks of surgery (group 2) and patients who received

Characteristics of the patients

Of 1390 patients who were seen between 1997 and 2004, 394 patients had stage III disease and were submitted to a surgical procedure followed by platinum-based chemotherapy. The median follow-up was 19 months (range 2–91 months). The median age of the patients was 62 years (range 23–85 years old). Most patients had macroscopic (>2 cm) disease after debulking surgery (n=283). Most patients (n=327) had a good performance status (ECOG scale 0 or 1). After surgery, 30 patients had no residual

Time from surgery to chemotherapy does not affect survival

We have analysed a large series of stage III ovarian cancer patients treated with platinum-based chemotherapy in a single centre and the interval between debulking surgery and beginning of chemotherapy was not an independent prognostic factor for overall survival. Our data enhances those previously published. Although four studies1, 3, 4, 5 have addressed the association between the timing of chemotherapy and patient outcome, our study has focussed on a uniform population of patients with stage

Conclusion

In conclusion, our study suggests that the interval between debulking surgery and beginning of chemotherapy is not an independent prognostic factor for overall survival, even in patients treated with chemotherapy more than 8 weeks after surgery. The type of procedure, performance status and post-chemotherapy CA-125 were independent prognostic factors in patients with stage III ovarian cancer.

References (23)

  • R.S. Bell et al.

    Timing of chemotherapy and surgery in a murine osteosarcoma model

    Cancer Res

    (1988)

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