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Quantitation of Intra-peritoneal Ovarian Cancer Metastasis
Published on: July 18, 2016
Clinical parameters affecting survival outcomes in patients with low-grade serous ovarian carcinoma: an international
Taymaa May1, Marcus Bernardini2, Stephanie Lheureux2
1From the Division of Gynecologic Oncology, University Health Network, Princess Margaret Cancer Centre, Toronto, Ont. (May, Bernardini, Tone); the Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ont. (May, Bernardini); the Division of Medical Oncology, Department of Medicine, Princess Margaret Cancer Centre, Toronto, Ont. (Lheureux); the Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Australia (Johnatty); the Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia (Webb); the Department of Medical Oncology, Prince of Wales Hospital, Sydney, Australia (Friedlander); the Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen Nuremberg, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany (Beckmann, Hein); the Division of Hematology and Oncology, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, Calif. (Fasching); the Division of Gynecologic Oncology, Department of Obstetrics and Gynaecology and Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium (Vanderstichele, Vergote); the Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain (Benitez, García, Rodriguez-Antona); the Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain (Benitez, García, Rodriguez-Antona); the Department of Obstetrics and Gynecology, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii (Carney); the Gynaecology Research Unit, Hannover Medical School, Hanover, Germany (Dörk); the Women's Cancer Research Center, Magee-Womens Research Institute and Hillman Cancer Center, Pittsburgh, Penn. (Modugno); the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Penn. (Modugno); the Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan (Matsuo); the Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan (Matsuo); the Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark (Jensen, Kjær); the Department of Gynaecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark (Kjær); the Department of Health Sciences Research, Mayo Clinic, Rochester, Minn. (Goode); the Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii (Wilkens); the Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Fla. (Phelan); the Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC (Berchuck, Riggan); the Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, Mass. (Cramer, Terry); the Harvard T.H. Chan School of Public Health, Boston, Mass. (Cramer, Terry); the Cancer Prevention and Control Program, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ (Bandera); the New Jersey Department of Health and Senior Services, Mercerville, NJ (Paddock); the School of Public Health, University of Medicine and Dentistry of New Jersey, Piscataway, NJ (Paddock); the Department of Gynecology and Obstetrics, Haukeland University Horpital, Bergen, Norway (Bjørge, Vestrheim Thomsen); the Centre for Cancer Biomarkers CCBIO, Department of Clinical Science, University of Bergen, Bergen, Norway (Bjørge, Vestrheim Thomsen); the Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands (Aben, Kiemeney); the Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands (Aben); the Department of Gynaecology, Radboud University Medical Center, Nijmegen, The Netherlands (van Altena); the Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Ore. (Pejovic); the Knight Cancer Institute, Oregon Health & Science University, Portland, Ore. (Pejovic); the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Md. (Wentzensen); The Juliane Marie Centre, Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark (C. Høgdall); the Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK (Song); the Cancer Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK (Eccles); the Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine, Stanford, Calif. (McGuire); the Department of Genetics and Genomic Sciences, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY (Rothstein, Sieh); the Department of Epidemiology, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, Calif. (Ziogas); the Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia (deFazio, Kennedy); the Department of Gynaecological Oncology, Westmead Hospital, Sydney, Australia (deFazio, Kennedy); the Department of Pathology and Laboratory Diagnostics, the Maria Sklodowska-Curie Institute - Oncology Center, Warsaw, Poland (Kupryjanczyk); and the Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Ont. (Jiang) Taymaa.May@uhn.ca.
Background:
Women with low-grade ovarian serous carcinoma (LGSC) benefit from surgical treatment; however, the role of chemotherapy is controversial. We examined an international database through the Ovarian Cancer Association Consortium to identify factors that affect survival in LGSC.
Methods:
We performed a retrospective cohort analysis of patients with LGSC who had had primary surgery and had overall survival data available. We performed univariate and multivariate analyses of progression-free survival and overall survival, and generated Kaplan-Meier survival curves.
Results:
Of the 707 patients with LGSC, 680 (96.2%) had available overall survival data. The patients' median age overall was 54 years. Of the 659 patients with International Federation of Obstetrics and Gynecology stage data, 156 (23.7%) had stage I disease, 64 (9.7%) had stage II, 395 (59.9%) had stage III, and 44 (6.7%) had stage IV. Of the 377 patients with surgical data, 200 (53.0%) had no visible residual disease. Of the 361 patients with chemotherapy data, 330 (91.4%) received first-line platinum-based chemotherapy. The median follow-up duration was 5.0 years. The median progression-free survival and overall survival were 43.2 months and 110.4 months, respectively. Multivariate analysis indicated a statistically significant impact of stage and residual disease on progression-free survival and overall survival. Platinum-based chemotherapy was not associated with a survival advantage.
Conclusion:
This multicentre analysis indicates that complete surgical cytoreduction to no visible residual disease has the most impact on improved survival in LGSC. This finding could immediately inform and change practice.
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