Survival Outcomes of Recurrent Epithelial Ovarian Cancer: Experience from a Thailand Northern Tertiary Care Center

Abstract

To assess survival outcomes in a retrospective study, recurrent epithelial ovarian cancer patients were divided into three groups according to the platinum free interval as follows: platinum refractory that included the patients with tumor progression during treatment; platinum resistant and platinum sensitive that included the patients with tumor progression less than or more than six months, respectively. Clinical data for tumor progression in epithelial ovarian cancer patients treated at Chiang Mai University Hospital between January, 2006 and December, 2010 were reviewed. Thirty-nine patients were in the platinum refractory group while 27 were in the platinum resistant group and 75 in the platinum sensitive group. The mean age, the parity, the administration of neoadjuvant chemotherapy and the serous type did not significantly different across groups while the mean total number of chemotherapy regimens, the early stage patients, the patients with complete surgery and the surviving patients were significant more frequent in the platinum sensitive group. Regarding subsequent treatment after tumor recurrence, 87.2% underwent chemotherapy. With the median follow up time at 29 months, the median overall survival rates were 20 months, 14 months and 42 months in platinum refractory, platinum resistant and platinum sensitive groups, respectively (p<0.001). In addition, when the platinum sensitive patients developed the next episode of tumor progression, the median progression free interval time was only three to four months. In conclusion, the outcomes for platinum refractory the and platinum resistant groups was poorer than the platinum sensitive group. However, subsequent progression in the platinum sensitive group was also associated with a poor outcome.

Potential predictors for chemotherapeutic response and prognosis in epithelial ovarian, fallopian tube and primary peritoneal cancer patients treated with platinum-based chemotherapy

“…Thus, the elevated neutrophil-to-lymphocyte ratios (NLRs) and platelet-to-lymphocyte ratios (PLRs) in many solid tumors can be associated with worse prognoses [5]. In addition, other clinical manifestations such as the presence of malignant ascites, a suboptimal residual tumor, a high cancer antigen 125 (CA125) reading and a high-grade tumor can also be related to poorer outcomes [5][6][7]. However, studies to predict the factors involved in platinum-based chemotherapeutic responses are still limited.…”

Prevalence of Tissue BRCA Gene Mutation in Ovarian, Fallopian Tube, and Primary Peritoneal Cancers: A Multi-Institutional Study

“…When the recurrences occur either later than 6 months or sooner after the last therapy, the diseases are regarded as platinum-sensitive or platinum-resistant, respectively. Platinum-based chemotherapy is usually used for platinum-sensitive disease; whereas, other non-platinum chemotherapies can be the option for platinum-resistant diseases (Jansaka and Suprasert, 2014;Webber and Friedlander, 2017).…”

“…Unfortunately, the patients with platinum-sensitive disease, who have responded to platinum-based chemotherapy re-induction, may have subsequent recurrences. The second-relapse generally have lower responses to treatment with platinum or other chemotherapeutic drugs (Jansaka and Suprasert, 2014;Webber and Friedlander, 2017). Hence, maintenance therapy after primary treatment has emerged in order to extend the progression-free period and survival.…”

Prevalence of Tissue BRCA Gene Mutation in Ovarian, Fallopian Tube and Primary Peritoneal Cancer: Thai Multi-institutional Study

“…If the recurrences occur either later than 6 months or sooner after the last therapy, the diseases are regarded as platinum-sensitive or platinumresistant respectively. Platinum-based chemotherapy is usually used for platinum-sensitive disease whereas other non-platinum chemotherapies would be the option for platinum-resistant disease [3,4].…”

“…Unfortunately, the patients with platinum-sensitive disease who have responded to platinum-based chemotherapy re-induction may have subsequent recurrences. The second-relapse generally have lower responses to treatment with platinum or other chemotherapeutic drugs [3,4]. Hence, maintenance therapy after primary treatment has emerged in order to extend the progression-free period and survival.…”