Timing of interval debulking surgery and postoperative chemotherapy after neoadjuvant chemotherapy in advanced epithelial ovarian cancer: a multicenter real-world study
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Published:2023-06-27
Issue:1
Volume:16
Page:
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ISSN:1757-2215
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Container-title:Journal of Ovarian Research
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language:en
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Short-container-title:J Ovarian Res
Author:
Liu Xingyu, Zhao Yingjun, Jiao Xiaofei, Yu Yang, Li Ruyuan, Zeng Shaoqing, Chi Jianhua, Ma Guanchen, Huo Yabing, Li Ming, Peng Zikun, Liu Jiahao, Zhou Qi, Zou Dongling, Wang Li, Li Qingshui, Wang Jing, Yao Shuzhong, Chen Youguo, Ma Ding, Hu Ting, Gao QingleiORCID
Abstract
Abstract
Background
To investigate the prognostic relevance of the time to interval debulking surgery (TTS) and the time to postoperative adjuvant chemotherapy (TTC) after the completion of neoadjuvant chemotherapy (NACT).
Methods
A retrospective real-word study included 658 patients with histologically confirmed advanced epithelial ovarian cancer who received NACT at seven tertiary hospitals in China from June 2008 to June 2020. TTS was defined as the time interval from the completion of NACT to the time of interval debulking surgery (IDS). TTC was defined as the time interval from the completion of NACT to the initiation of postoperative adjuvant chemotherapy (PACT).
Results
The median TTS and TTC were 25 (IQR, 20–29) and 40 (IQR, 33–49) days, respectively. Patients with TTS > 25 days were older (55 vs. 53 years, P = 0.012) and received more NACT cycles (median, 3 vs. 2, P = 0.002). Similar results were observed in patients with TTC > 40 days. In the multivariate analyses, TTS and TTC were not associated with PFS when stratified by median, quartile, or integrated as continuous variables (all P > 0.05). However, TTS and TTC were significantly associated with worse OS when stratified by median (P = 0.018 and 0.018, respectively), quartile (P = 0.169, 0.014, 0.027 and 0.012, 0.001, 0.033, respectively), or integrated as continuous variables (P = 0.018 and 0.011, respectively). Similarly, increasing TTS and TTC intervals were associated with a higher risk of death (Ptrend = 0.016 and 0.031, respectively) but not with recurrence (Ptrend = 0.103 and 0.381, respectively).
Conclusion
The delays of IDS and PACT after the completion of NACT have adverse impacts on OS but no impacts on PFS, which indicates that reducing delays of IDS and PACT might ameliorate the outcomes of ovarian cancer patients treated with NACT.
Funder
National Key R&D Program of China National Natural Science Foundation of China Major Project of Chinese Society of Medical Education Beijing Xisike Clinical Oncology research foundation
Publisher
Springer Science and Business Media LLC
Subject
Obstetrics and Gynecology,Oncology
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