Delay in adjuvant chemotherapy administration for patients with FIGO stage I epithelial ovarian carcinoma is associated with worse survival; an analysis of the National Cancer Database.

Autor: Nasioudis D; Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA, USA. Electronic address: dimitrios.nasioudis@uphs.upenn.edu., Mastroyannis SA; Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA, USA., Ko EM; Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA, USA., Haggerty AF; Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA, USA., Cory L; Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA, USA., Giuntoli RL 2nd; Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA, USA., Kim SH; Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA, USA., Morgan MA; Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA, USA., Latif NA; Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA, USA.
Jazyk: angličtina
Zdroj: Gynecologic oncology [Gynecol Oncol] 2022 Aug; Vol. 166 (2), pp. 263-268. Date of Electronic Publication: 2022 Jun 03.
DOI: 10.1016/j.ygyno.2022.05.015
Abstrakt: Objective: The administration of adjuvant chemotherapy within 42 days from surgery is one of the proposed quality measures for patients with epithelial ovarian cancer (EOC). The aim of the present study was to evaluate the impact of chemotherapy delay in the survival of patients with stage I EOC.
Methods: The National Cancer Database was accessed, and patients diagnosed between 2004 and 2015 with FIGO stage I EOC who received multi-agent chemotherapy were identified. Overall survival (OS) was compared between patients who received chemotherapy <6 weeks and 6-12 weeks from surgery with the log-rank test following generation of Kaplan-Meier curves. Cox model was constructed to control for a priori selected confounders.
Results: A total of 8549 patients who received adjuvant chemotherapy at a median 35 days from surgery (interquartile range 19) were identified; 67.7% received adjuvant chemotherapy <6 weeks from surgery while 32.3% experienced a delay. Patients who experienced a delay were more likely to have comorbidities (18.4% vs 14.9%, p < 0.001), and be managed in non-academic facilities (57.1% vs 53.2%, p = 0.001). Patients who experienced a delay had worse OS compared to those who did not, p < 0.001; 5-year OS rates 85.7% and 89.7%, respectively. For patients with high-grade serous tumors, those who experienced a delay had a 5-yr OS of 81.9% compared to 88.6% for those who did not, p < 0.001. After controlling for age, race, presence of comorbidities, insurance status, tumor histology and grade, performance of lymphadenectomy and substage, chemotherapy delay was associated with worse survival (HR: 1.25, 95% CI: 1.10, 1.42).
Conclusions: For patients with early stage EOC administration of adjuvant chemotherapy within 6 weeks from surgery was associated with better overall survival, especially for those with stage IC disease.
Competing Interests: Declaration of Competing Interest None related to this study. RL: medical monitor for CAPRI trial by Astra Zeneca. AH: GSK research fund, GSK advisory board, Honoraria: Axess ovarian cancer lecture.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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