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Treatment of Chemotherapy-Induced Anemia in Ovarian Cancer P... : International Journal of Gynecological Cancer
Abstract
Objective:
Considering the paucity of data relating
erythropoiesis-stimulating agent (ESA) use to ovarian cancer survival,
our objective was to evaluate the effect of ESA as used for the
treatment of chemotherapy-induced anemia (CIA) on survival in ovarian
cancer patients.
Materials and Methods:
A multi-institution retrospective
chart review was performed on ovarian cancer patients. Data collection
included patient demographic, surgicopathologic, chemotherapy, ESA, and
survival data. Patients were stratified by ever-use of ESA and were
compared using appropriate statistical methods.
Results: A total of 581 patients were eligible for
analysis with 39% (n = 229) patients with ever-use of ESA (ESA-YES) and
61% (n = 352) never-use ESA (ESA-NO). Mean age was 60.4 years with most
patients having stage IIIC (60%) of papillary serous histological
diagnosis (64%) with an optimal cytoreduction (67%). Median follow-up
for the cohort was 27 months. Both ESA-YES and ESA-NO groups were
similar regarding age, body mass index, race, stage, histological
diagnosis, and debulking status. Compared with the ESA-NO group, ESA-YES
patients were significantly more likely to experience recurrence (56%
vs 80%, P < 0.001) and death (46% vs 59%, P = 0.002). Kaplan-Meier
curves demonstrated a significant reduction in progression-free survival
for ESA-YES patients (16 vs 24 months, P < 0.001); however, overall
survival was statistically similar between the 2 groups (38 vs 46
months, P = 0.10). When stratifying by ever experiencing a CIA, ESA-YES
patients demonstrated a significantly worse progression-free survival
(17 vs 24 months, P = 0.02) and overall survival (37 vs 146 months, P
< 0.001).
Conclusions:
Our data evaluating the use of ESA as a
treatment of CIA in ovarian cancer patients are similar to reports in
other tumor sites. Considering that patients who used ESA were more
likely to experience recurrence and death and to have decreased
survival, the use of ESA in ovarian cancer patients should be limited.
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