Survival and prognostic factors in early-stage epithelial ovarian carcinoma treated with taxane-based adjuvant chemotherapy

• Published in: International journal of gynecological cancer Vol. 17; no. 6; pp. 1231 - 1237
• Main Authors: Skírnisdóttir, I, Sorbe, B
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.11.2007
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bridged-Ring Compounds - therapeutic use; Carboplatin - therapeutic use; Carcinoma - diagnosis; Carcinoma - drug therapy; Carcinoma - surgery; Chemotherapy; Chemotherapy, Adjuvant; Disease-Free Survival; Female; Humans; Logistic Models; Lymphatic system; Medical prognosis; Middle Aged; Ovarian cancer; Ovarian Neoplasms - diagnosis; Ovarian Neoplasms - drug therapy; Ovarian Neoplasms - surgery; Patients; Prospective Studies; Taxoids - therapeutic use
• ISSN: 1048-891X; 1525-1438
• DOI: 10.1111/j.1525-1438.2007.00928.x

The present study was undertaken with the question about the outcome (recurrence-free survival, [RFS]) after adjuvant chemotherapy with taxane and carboplatin in the early stages of epithelial ovarian cancer after primary surgery. Treatment-related toxicity was also evaluated. A total of 113 patients were included in this study. The 5-year RFS rate for all 113 patients treated with adjuvant chemotherapy including taxane and carboplatin after primary surgery was 79%. The 5-year RFS rate for 85 patients in FIGO stage I was 85% and for 18 patients in FIGO stage II, it was 44%. For clear-cell carcinomas, the RFS was 87%. In univariate analysis, recurrent disease was associated with both FIGO stage and tumor grade, but in multivariate logistic regression analysis of prognostic factors for tumor recurrences, only FIGO stage (stage I versus stage II) was a significant and independent prognostic factor. However, an odds ratio (OR) of 1.9 for tumor grade (grade 3 versus grades 1-2) demonstrated two times increased risk for recurrence in a patient with a grade 3 tumor compared with grade 1-2 tumors. Furthermore, an OR of 0.39 for lymph node sampling versus no sampling meant 61% reduced risk for recurrence for a patient who had undergone lymph node sampling at surgical staging laparotomy. The major toxicities in the present study were myelosuppression (46%) and neurotoxicity (34%). Despite the use of prophylaxis, severe paclitaxel-related hypersensitivity occurred in three patients (3%).