Impact of interval from definitive surgery to initiation of adjuvant chemotherapy (ISC) on survival in advanced epithelial ovarian cancer

Heo, Eun Jeong; Paik, E Sun; Choi, Hyun-Jin; Kim, W.Y.; Lee, Y.Y.; Choi, Chel Hun; Kim, T.J.; Lee, J.W.; Kim, B.G.; Bae, Duk Soo

doi:10.1016/j.ygyno.2016.04.313

Cited by 3 publications

(7 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The 4 study-specific HRs ranged from a low of 1.01 (95% CI: 1.00–1.02, I 2 = 2.75%, P = 0.43) after omitting the study by Heo et al . 19 to a high of 1.06 (95% CI: 1.01–1.12, I 2 = 4.12%, P = 0.25) after omitting the study by Seagle et al . 25 .…”

Section: Resultsmentioning

confidence: 95%

“…Of these, 11 were excluded because of the inclusion and exclusion criteria. Finally, 15 studies 10 – 13 , 15 , 19 – 28 were included in the present meta-analysis (Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Notably, when initiation time of adjuvant chemotherapy exceeded 25 days, the complete resection group (i.e., stage IV) encountered an increased risk of death. Additionally, two recent retrospective cohort studies 13 , 19 from Asia published their results, although one of them is a meeting abstract 19 . Several potential biological theoretical rationales may explain the benefits of initiating adjuvant chemotherapy without delay after curative surgery.…”

Section: Discussionmentioning

confidence: 99%

“…We followed standard criteria for conducting and reporting this meta-analysis 30 . Additionally, we also included an unpublished study 19 and searched the reference sections of the studies that were included in our study to identify publications for further potentially relevant articles 31 – 34 .…”

Section: Methodsmentioning

confidence: 99%

“…To the best of our knowledge, there has been no quantitative assessment and dose-response analysis of published findings on this topic. Notably, several important studies 13 , 19 , 20 with large sample sizes were published after their study. Herein, to update the evidence as well as further clarify the relationship between initiation time of adjuvant chemotherapy and the prognosis of ovarian cancer patients, we carried out this dose-response meta-analysis of epidemiological studies.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Relationship between initiation time of adjuvant chemotherapy and survival in ovarian cancer patients: a dose-response meta-analysis of cohort studies

Liu

Zhang

et al. 2017

Sci Rep

View full text Add to dashboard Cite

Although several studies have previously investigated the association between the initiation time of adjuvant chemotherapy and survival in ovarian cancer, inconsistencies remain about the issue.We searched PubMed and Web of Science through the May 24, 2017 to identify cohort studies that investigated the aforementioned topic. Fourteen studies with 59,569 ovarian cancer patients were included in this meta-analysis. We conducted meta-analyses comparing the longest and shortest initiation time of adjuvant chemotherapy and dose-response analyses to estimate summary hazards ratios (HRs) and 95% confidence intervals (CIs). A random-effects model was used to estimate HRs with 95% CIs. When comparing the longest with the shortest category of initiation time of adjuvant chemotherapy, the summary HR was 1.18 (95% CI: 1.06-1.32; I 2 = 17.6; n = 7) for overall survival. Additionally, significant dose-response association for overall survival was observed for each week delay (HR = 1.04; 95% CI: 1.00-1.09; I 2 = 9.05; n = 5). Notably, these findings were robust in prospective designed cohort studies as well as studies with advanced stage (FIGO III-IV) patients. No evidence of publication bias was observed. In conclusion, prolonged initiation time of adjuvant chemotherapy is associated with a decreased overall survival rate of ovarian cancer, especially in patients with advanced stage ovarian cancer.Epithelial ovarian cancer is the most lethal gynecologic malignancy 1, 2 , with nearly 22,280 new cases diagnosed in the United States resulting in 14,240 deaths in 2016 2 . It is the seventh leading cause of cancer and the eighth leading cause of cancer related deaths among women worldwide 1 . Approximately 75% of patients with this disease are diagnosed in advanced stages 3 which were probably attributed to no specific clinical manifestations and effective screening methods 4 . Relative survival at 5 years was 89%, 70%, 36%, and 17%, and at 10 years relative survival was 84%, 59%, 23%, and 8% for stages I, II III, and IV, respectively 5 . Due to the relatively poor prognosis and lack of standard treatment for advanced ovarian cancer currently, primary tumor resection surgery followed by Platinum-taxane chemotherapy is the most common and accepted treatment method 6 .Several experimental studies [7][8][9] showed that the remove of the primary cancer could promote cancer growth; likewise, time interval from surgery to chemotherapy influence the growth of metastasis, and an earlier start of chemotherapy offered a remarkable advantage in preventing systemic relapse. However, the relationship between initiation time of adjuvant chemotherapy in ovarian cancer and prognosis from epidemiological studies has remained controversial. Some studies [10][11][12] suggested that shorter initiation time of adjuvant chemotherapy seems to have a predictive value for the prognosis of ovarian cancer patients. Nevertheless, other studies 13-15 did not draw a clear conclusion about the aforementioned association. Additionally, there might be a differen...

show abstract

Section: Resultsmentioning

confidence: 95%

“…Of these, 11 were excluded because of the inclusion and exclusion criteria. Finally, 15 studies 10 – 13 , 15 , 19 – 28 were included in the present meta-analysis (Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Relationship between initiation time of adjuvant chemotherapy and survival in ovarian cancer patients: a dose-response meta-analysis of cohort studies

Liu

Zhang

et al. 2017

Sci Rep

View full text Add to dashboard Cite

show abstract

Prognostic Impact of the Time Interval between Surgery and Postoperative Adjuvant Chemotherapy in Epithelial Carcinoma of the Ovary

Yip

Chan

2021

Hong Kong Journal of Radiology

View full text Add to dashboard Cite

Introduction: Multiple studies have evaluated the prognostic impact of the time interval (TI) between initial surgery and adjuvant chemotherapy for epithelial ovarian cancer with different time intervals and inconclusive results. The aim of the present study was to evaluate the prognostic impact of a longer interval of 42 days. Methods: In a retrospective single-centre analysis, data were collected for all patients with epithelial ovarian cancer treated between 2007 and 2014. We divided patients by TI: ≤42 days and >42 days. The disease-free survival and overall survival (OS) between the two groups were compared. A Cox regression model was used to evaluate different prognostic factors. A p value <0.05 was considered statistically significant. Results: The median follow-up time was 73 months. Among those with postoperative residual disease (n = 30), TI of >42 days was associated with significantly worse OS (hazard ratio = 3.37, 95% confidence interval = 1.23-9.25, p = 0.02). In cases with residual disease after surgery, the Cox proportional model showed the presence of ascites (p = 0.03) and postoperative CA125 level (p = 0.03) were independent prognostic factors for DFS. TI >42 days (p = 0.03) was an independent negative prognostic factor for OS along with grading (p = 0.05) and presence of ascites (p < 0.01). Conclusion: Our study showed that patients with residual disease after initial surgery had inferior OS when TI was >42 days. Adjuvant chemotherapy in these patients should be started ≤42 days after surgery.

show abstract

Prognostic Influence of the Time Interval between Surgery and Chemotherapy in Epithelial Ovarian Cancer

Liu

Gong

et al. 2018

J. Cancer

View full text Add to dashboard Cite

The influence of time to chemotherapy (TTC) on recurrence and survival among epithelial ovarian cancer (EOC) patients still remains unknown. This single center retrospective cohort study was conducted on 489 EOC patients who underwent surgery followed by taxane- plus platinum-based chemotherapy in the Shengjing Hospital of China Medical University between 2011 and 2015. The Multivariate cox proportional regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for progression-free survival (PFS) and overall survival (OS) after adjustment for potential confounders. The median follow-up duration was 2.97 years (inter-quartile range from 2.11 to 4.13 years). The recurrence and mortality rate of the all patients was 50.9% (249/489) and 43.6% (213/489), respectively. Having comorbidity, residual disease, ascites, and advanced FIGO stage (III-IV) was associated worse PFS and OS of EOC patients. Compared to TTC less than 14 days, delayed TTC (more than 28 days) was associated with a worse PFS (HR=1.36; 95%CI: 0.96-1.92) and OS (HR=1.38; 95%CI: 0.95-2.00). Notably, in EOC patients with advanced stage, delayed TTC (more than 28 days) was associated with worse PFS (HR=1.51; 95%CI: 1.02-2.24) and OS (HR=1.53; 95%CI: 1.01-2.32) when comparing to TTC less than 14 days. In conclusion, delayed TTC was associated with higher rates of EOC recurrence and survival among these patients with advanced stage. The findings of the present study may provide evidence for gynecologist as well as these ovarian cancer patients to make further decision for the treatment.

show abstract

Impact of interval from definitive surgery to initiation of adjuvant chemotherapy (ISC) on survival in advanced epithelial ovarian cancer

Cited by 3 publications

References 0 publications

Relationship between initiation time of adjuvant chemotherapy and survival in ovarian cancer patients: a dose-response meta-analysis of cohort studies

Relationship between initiation time of adjuvant chemotherapy and survival in ovarian cancer patients: a dose-response meta-analysis of cohort studies

Prognostic Impact of the Time Interval between Surgery and Postoperative Adjuvant Chemotherapy in Epithelial Carcinoma of the Ovary

Prognostic Influence of the Time Interval between Surgery and Chemotherapy in Epithelial Ovarian Cancer

Contact Info

Product

Resources

About