Survival in Women With Grade 1 Serous Ovarian Carcinoma

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 122; no. 2; pp. 225 - 232
• Main Authors: Nickles Fader, Amanda, Java, James, Ueda, Stefanie, Bristow, Robert E., Armstrong, Deborah K., Bookman, Michael A., Gershenson, David M.
• Format: Journal Article
• Language: English
• Published: United States by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved 01.08.2013
• Subjects: Aged; Cystadenocarcinoma, Serous - mortality; Cystadenocarcinoma, Serous - pathology; Cystadenocarcinoma, Serous - therapy; Female; Humans; Kaplan-Meier Estimate; Middle Aged; Neoplasm Recurrence, Local - mortality; Neoplasm Recurrence, Local - pathology; Ovarian Neoplasms - mortality; Ovarian Neoplasms - pathology; Ovarian Neoplasms - therapy; Ovary - pathology; Randomized Controlled Trials as Topic; United States - epidemiology; United States
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1097/AOG.0b013e31829ce7ec

To examine clinicopathologic variables associated with survival among women with low-grade (grade 1) serous ovarian carcinoma enrolled in a phase III study. 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. 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). Surgical cytoreduction to microscopic residual was associated with improved progression-free and overall survival in women with advanced-stage low-grade serous ovarian carcinoma. ClinicalTrials.gov, www.clinicaltrials.gov, NCT00011986. II.