Low-grade serous carcinoma (LGSC): A Canadian multicenter review of practice patterns and patient outcomes
| Autor: | Anna V. Tinker, Sarah Glaze, Martin Köbel, Mark S. Carey, Monalisa Sur, Andrea Cheung, Laurie Elit, Hannah Kim, Melica Nourmoussavi, Lesley F. Roberts, Marta Llaurado Fernandez, C. Blake Gilks, Amy Dawson, Janice S. Kwon, Kurosh Rahimi, Kara Matheson, Diane Provencher, Alice Lytwyn, Paul Hoskins, Saul L. Offman, Jennifer Santos, Stephanie Scott |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
0301 basic medicine medicine.medical_specialty Paclitaxel Referral Serous carcinoma medicine.medical_treatment Disease Carboplatin Cohort Studies 03 medical and health sciences 0302 clinical medicine Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Practice Patterns Physicians' Stage (cooking) Aged Neoplasm Staging Retrospective Studies Ovarian Neoplasms Chemotherapy Proportional hazards model business.industry Obstetrics and Gynecology Retrospective cohort study Middle Aged medicine.disease Progression-Free Survival Cystadenocarcinoma Serous 3. Good health Survival Rate Treatment Outcome 030104 developmental biology Oncology 030220 oncology & carcinogenesis Female Cisplatin Neoplasm Grading business Ovarian cancer |
| Zdroj: | Gynecologic Oncology. 157:36-45 |
| ISSN: | 0090-8258 |
| DOI: | 10.1016/j.ygyno.2020.01.021 |
| Popis: | Patients with advanced low-grade serous carcinoma (LGSC) have poor long-term survival rates. As a rare histotype, there are uncertainties regarding the use of current therapies. Thus, we studied practice patterns and treatment outcomes as part of a national initiative to better understand and improve the care of women with advanced LGSC.This retrospective cohort study was conducted in 5 Canadian referral institutions from 2000 to 2016. Data collection and pathology reporting were standardized. Outcome measures included overall survival (OS), progression-free survival (PFS), progression-free intervals (PFI), and time to next treatment (TTNT). Cox regression analysis was used to evaluate the effects of clinical and pathologic factors on outcomes and prognosis.There were 134 patients (stage II-IV) with a median follow-up of 32.4 months (range 1.6-228). Four primary treatments were compared across institutions: 1) surgery followed by chemotherapy (56%), 2) neoadjuvant chemotherapy (NACT) followed by surgery (27%), 3) surgery alone (9%), and 4) surgery followed by anti-hormone therapy (4%). Primary platinum/paclitaxel chemotherapy was used in 81%. Patients treated with NACT had worse PFS. Multivariable Cox regression analysis identified lesser residual disease, younger age, and primary peritoneal origin as variables significantly associated with better OS/PFS (p 0.03). One institution had significantly better PFS than the others (p = 0.025), but this finding could be related to a higher frequency of primary peritoneal LGSC. PFI and TTNT intervals in patients with relapsed disease were not significantly different after the first relapse irrespective of treatment type.There are notable differences in practice patterns across Canada. This underscores the need for ongoing strategies to measure, evaluate and achieve optimal patient outcomes for women with advanced LGSC. |
| Databáze: | OpenAIRE |
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