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The number of cycles of neoadjuvant chemotherapy is associated with prognosis of stage IIIc–IV high-grade serous ovarian cancer
Abstract
Conclusion
NAC
cycles, CA-125 decreasing kinetics, and optimal debulking are
independently associated with the prognosis of patients with advanced
stage HG-SOC who underwent NAC/IDS and achieved CCR. The number of
administered NAC cycles should not exceed 4.
Objective
No
consensus exists on the number of chemotherapy cycles to be
administered before and after interval debulking surgery (IDS) in
patients with advanced stage epithelial ovarian cancer. The present
study aims to explore the optimal number of cycles of neoadjuvant
chemotherapy (NAC) and post-operation chemotherapy to treat the
International Federation of Gynecology and Obstetrics stage IIIc–IV
high-grade serous ovarian cancer (HG-SOC).
Materials and Methods
A
total of 129 IIIc–IV stage HG-SOC cases were retrospectively analyzed.
Cases were comprised of patients who underwent NAC followed by IDS and
who achieved clinical complete response (CCR) at the end of primary
therapy. Patients were recruited from the Jiangsu Institute of Cancer
Research between 1993 and 2013. Optimal IDS-associated factors were
explored with logistic regression. The association between
progression-free survival (PFS), overall survival (OS) duration, and
covariates was assessed by Cox proportional hazards model and log-rank
test.
Results
The median number of NAC cycle was 3 (range 1–8). CA-125 decreasing kinetics (p = 0.01)
was independently associated with optimal IDS. CA-125 decreasing
kinetics, optimal IDS, and NAC cycles was independently associated with
OS (p < 0.01, p < 0.01, p = 0.03, respectively) and PFS (p < 0.01, p < 0.01, p = 0.04,
respectively). The PFS of patients who underwent ≥5 NAC cycles was
shorter than those of patients who underwent <5 NAC cycles (12.3
versus 17.2 months). The PFS and OS of patients who underwent <5
cycles of adjuvant chemotherapy post-IDS were shorter than those of
patients who underwent ≥5 cycles (14.2 and 20.3 versus 21.2 and
28.8 months).
Conclusion
NAC
cycles, CA-125 decreasing kinetics, and optimal debulking are
independently associated with the prognosis of patients with advanced
stage HG-SOC who underwent NAC/IDS and achieved CCR. The number of
administered NAC cycles should not exceed 4.
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