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Abstract
Highlights
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- Survival for IP chemotherapy patients with no residual disease is unprecedented.
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- Prognostic factors include age, histology, and extent of residual disease.
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- More recurrences occur extraperitoneal for patients treated with IP chemotherapy.
Objectives
To
determine prognostic factors for survival in ovarian cancer patients
treated with intraperitoneal (IP) chemotherapy using ancillary data from
cooperative group clinical trials.
Methods
Data
were collected from 428 patients with stage III ovarian cancer who
underwent optimal surgical cytoreduction (< 1 cm) followed by IP
paclitaxel/platinum chemotherapy. Primary endpoints were progression
free survival (PFS) and overall survival (OS). Potential prognostic
variables were included in Cox proportional hazard regression models.
Multivariate analysis was conducted to identify independent prognostic
factors.
Results
Median PFS was
24.9 months (95% CI, 23.0-29.2) and median OS was 61.8 months (95% CI,
55.5-69.8). Predictors for PFS were histology, surgical stage and
residual disease. Age, histology, and residual disease were prognostic
for OS. There were no differences in the hazard ratio for death or
progression between patients with positive, negative, or unknown lymph
node status. For patients receiving IP chemotherapy (n=428), 36% of
patients had no residual disease with median PFS of 43.2 months (95% CI
32.5-60.4) and median OS of 110 months (95% CI, 60.0-161.3).
Conclusions
Age,
histology, and extent of residual disease were predictors of OS in
Stage III patients treated with IP chemotherapy following optimal
cytoreduction. Patients with no residual disease following primary
surgery that are treated with adjuvant platinum based IP chemotherapy
have survival measures that exceed any rates previously seen in this
population.
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