Does time interval between surgery and intraperitoneal chemotherapy administration in advanced ovarian cancer carry a prognostic impact? An NRG Oncology/Gynecologic Oncology Group study ancillary study

Gynecol Oncol. 2016 Dec;143(3):484-489. doi: 10.1016/j.ygyno.2016.10.003. Epub 2016 Oct 7.

Abstract

Objectives: To determine the relationship of the time from surgery to intraperitoneal (IP) chemotherapy (TSIC) initiation with survival of patients with stage III epithelial ovarian cancer (EOC) patients using ancillary data from cooperative group clinical trials.

Methods: Data from 420 patients with stage III EOC treated with IP chemotherapy under GOG-0114 and 172 were reviewed. The Cox proportional hazards model was used to evaluate independent prognostic factors and estimate their covariate-adjusted effects on PFS and OS.

Results: The median TSIC was 62.5days (interquartile range 28-83). The median TSIC was longer for patients in GOG-0114 vs those in GOG-172 (83 vs 26days, p<0.001). TSIC was significantly associated (p=0.049) with PFS: each 10% increase in TSIC (days) decreases the risk of progression by 3%. TSIC was not significantly associated with OS in this model. In a linear regression model, gross residual disease was significantly associated with shorter TSIC (R2 -0.141, 95%CI -0.217, -0.064, p<0.001). When only data from GOG-172 were considered, no statistical significant association was found between TSIC and PFS or OS.

Conclusions: In this ancillary data study, TSIC was not associated with improved OS in patients with stage III epithelial ovarian cancer. TSIC was significantly associated with PFS for the entire cohort, suggesting increase in PFS with longer TSIC. However, this was not found when only data from GOG 172 or GOG 114 were analyzed separately. Hence, the relationship between IP chemotherapy initiation and time from surgery needs to be studied further.

Keywords: NRG Oncology; Ovarian cancer; Time interval between surgery and IP chemo.

MeSH terms

  • Adenocarcinoma, Clear Cell / drug therapy*
  • Adenocarcinoma, Clear Cell / pathology
  • Aged
  • Antineoplastic Agents / administration & dosage*
  • Carcinoma, Endometrioid / drug therapy*
  • Carcinoma, Endometrioid / pathology
  • Carcinoma, Ovarian Epithelial
  • Chemotherapy, Adjuvant / methods*
  • Cytoreduction Surgical Procedures*
  • Disease-Free Survival
  • Female
  • Humans
  • Infusions, Parenteral / methods*
  • Middle Aged
  • Neoplasm Staging
  • Neoplasm, Residual
  • Neoplasms, Cystic, Mucinous, and Serous / drug therapy*
  • Neoplasms, Cystic, Mucinous, and Serous / pathology
  • Neoplasms, Glandular and Epithelial / drug therapy*
  • Neoplasms, Glandular and Epithelial / pathology
  • Ovarian Neoplasms / drug therapy*
  • Ovarian Neoplasms / pathology
  • Paclitaxel / administration & dosage*
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Survival Rate
  • Time Factors

Substances

  • Antineoplastic Agents
  • Paclitaxel