Prognostic factors and clinical outcome of patients with recurrent early-stage epithelial ovarian cancer: an Italian multicenter retrospective study

Autor: Paolo Zola, Luca Fuso, Angiolo Gadducci, Enrico Sartori, Stefania Cosio, Benedetta Sostegni
Jazyk: angličtina
Rok vydání: 2013
Předmět:
Oncology
medicine.medical_treatment
Pattern of failure
Clear Cell
Antineoplastic Combined Chemotherapy Protocols
80 and over
Mucinous
Stage (cooking)
Peritoneal Neoplasms
Aged
80 and over
Ovarian Neoplasms
Hazard ratio
Age Factors
Obstetrics and Gynecology
Middle Aged
Prognosis
Adenocarcinoma
Mucinous
Combined Modality Therapy
Survival Rate
Italy
Local
Female
Adult
medicine.medical_specialty
Prognostic variable
Cystadenocarcinoma
Adenocarcinoma
Young Adult
Internal medicine
medicine
Chemotherapy
Humans
Early-stage ovarian cancer
Surgery
Time to recurrence
Adenocarcinoma
Clear Cell
Aged
Cystadenocarcinoma
Serous
Endometrial Neoplasms
Follow-Up Studies
Neoplasm Grading
Neoplasm Recurrence
Local
Neoplasm Staging
Retrospective Studies
business.industry
Serous
Retrospective cohort study
medicine.disease
Confidence interval
Radiation therapy
Neoplasm Recurrence
Ovarian cancer
business
Popis: ObjectiveThe objective of this study was to assess the clinical outcome of patients with recurrent early-stage ovarian cancer.MethodsThe hospital records of 87 patients were reviewed. The median follow-up of survivors from recurrence was 87.6 months.ResultsThe 25%, 50%, and 75% quantiles of time to recurrence were 15, 25, and 44 months, respectively. The pelvis was the most common site of failure (39.1%), followed by abdomen (18.3%) and retroperitoneal nodes (18.3%). Treatment at recurrence consisted of chemotherapy in 46 patients, surgery plus chemotherapy in 29, surgery in 3, surgery plus radiotherapy in 2, and other therapies in 7. A macroscopically complete cytoreduction was obtained in 29 (85.2%) of the 34 patients who underwent secondary surgery. Five- and 7-year survival rates after recurrence were 34.3% and 29.6%. By log-rank test, survival after recurrence was related to patient age (≤60 vs >60 years; P = 0.001), time to recurrence (>15 vs ≤15 months; P = 0.049), site of recurrence (retroperitoneum vs pelvis vs other; P = 0.004), and surgery at recurrence (yes vs not; P = 0.001), but not to substage, histotype, grade, prior adjuvant chemotherapy, examination that detected recurrence, and chemotherapy at recurrence. On multivariate analysis, patient age (hazard ratio, 1.836; 95% confidence interval, 1.060-3.180) and surgical treatment at recurrence (hazard ratio, 1.972; 95% confidence interval, 1.084–3.587) were independent prognostic variables for survival after recurrence.ConclusionsPatient age and surgery at recurrence were independent prognostic variables for patients with recurrent early-stage ovarian cancer. When feasible, salvage surgery appears to give a survival advantage in this clinical setting.
Databáze: OpenAIRE
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