abstract
Three versus six cycles of adjuvant platinum-based chemotherapy in early stage clear cell ovarian carcinoma – A multi-institutional cohort
Highlights
- •Stage I–II OCCC survival similar after 3 or 6 cycles of platinum-based chemotherapy
- •Patients with early stage I and II OCCC may be candidates for a 3 cycle approach.
- •Optimal chemotherapy choice and duration for OCCC requires further study.
Abstract
Objectives
To
determine if 6 versus 3 cycles of adjuvant platinum-based chemotherapy
with or without taxane impacts survival in early stage ovarian clear
cell carcinoma (OCCC).
Methods
We
retrospectively identified all cases of stage I and II OCCC treated at 5
institutions from January 1994 through December 2011. Patients were
divided into 2 groups: those who received 3 versus 6 cycles of adjuvant
chemotherapy. Our cohort consisted of 210 patients with stage IA-II
disease, 116 of whom underwent full surgical staging. Cox proportional
hazards regression and Kaplan-Meier analyses were performed to evaluate
progression-free (PFS) and overall survival (OS) between groups.
Results
Among
210 eligible patients, the median age was 53 years (range 30–88). The
majority of patients were Caucasian (83.8%). All patients received
adjuvant chemotherapy with 90% receiving carboplatin and paclitaxel.
Thirty-eight (18.1%) patients received 3 cycles, and 172 (81.9%)
patients received 6 cycles of adjuvant treatment. Recurrence rate was
comparable between groups (18.4% vs. 27.3% for 3 vs. 6 cycles, p = 0.4).
There was no impact of 3 versus 6 cycles of chemotherapy on PFS (hazard
ratio [HR] 1.4) or OS
(HR 1.65) on univariate analysis. There was
no benefit to more chemotherapy in stratified analysis by stage nor on
multivariate analysis adjusting for the impact of stage. Subgroup
analysis of surgically staged patients also showed no difference in
survival between 3 versus 6 cycles of chemotherapy.
Conclusions
Three
cycles of platinum with or without taxane adjuvant chemotherapy were
comparable to 6 cycles with respect to recurrence and survival in
patients diagnosed with early stage ovarian clear cell carcinoma in this
retrospective multi-institutional cohort.
Condensation
Three
cycles of platinum with or without taxane adjuvant chemotherapy are
comparable to 6 cycles with respect to recurrence and survival in
patients diagnosed with early stage ovarian clear cell carcinoma in this
retrospective multi-institutional cohort.
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