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Published on: May 20, 2014
Survival in women with grade 1 serous ovarian carcinoma
Amanda Nickles Fader1, James Java, Stefanie Ueda
1Johns Hopkins Medical Institutions, Baltimore, Maryland; the Gynecologic Oncology Group Statistical and Data Center, Roswell Park Cancer Institute, Buffalo, New York; the University of California San Francisco, Comprehensive Cancer Center, San Francisco, and the University of California, Irvine Medical Center, Orange, California; the University of Arizona, Tucson, Arizona; and the University of Texas, MD Anderson Cancer Center, Houston, Texas.
Objective:
To examine clinicopathologic variables associated with survival among women with low-grade (grade 1) serous ovarian carcinoma enrolled in a phase III study.
Methods:
This was an ancillary data analysis of Gynecologic Oncology Group protocol 182, a phase III study of women with stage III-IV epithelial ovarian carcinoma treated with carboplatin and paclitaxel compared with triplet or sequential doublet regimens. Women with grade 1 serous carcinoma (a surrogate for low-grade serous disease) were included in the analysis.
Results:
Among the 3,686 enrolled participants, 189 had grade 1 disease. The median age was 56.5 years and 87.3% had stage III disease. The median follow-up time was 47.1 months. Stratification according to residual disease after primary surgery was microscopic residual in 24.9%, 0.1-1.0 cm of residual in 51.3%, and more than 1.0 cm of residual in 23.8%. On multivariate analysis, only residual disease status (P=.006) was significantly associated with survival. Patients with microscopic residual had a significantly longer median progression-free (33.2 months) and overall survival (96.9 months) compared with those with residual 0.1-1.0 cm (14.7 months and 44.5 months, respectively) and more than 1.0 cm of residual disease (14.1 months and 42.0 months, respectively; progression-free and overall survival, P<.001). After adjustment for other variables, patients with low-grade serous carcinoma with measurable residual disease had a similar adjusted hazard ratio for death (2.12; P=.002) as their high-grade serous carcinoma counterparts with measurable disease (2.31; P<.001).
Conclusions:
Surgical cytoreduction to microscopic residual was associated with improved progression-free and overall survival in women with advanced-stage low-grade serous ovarian carcinoma.
Clinical Trial Registration:
ClinicalTrials.gov, www.clinicaltrials.gov, NCT00011986.
Level Of Evidence:
II.
