Prognostic factors of early stage epithelial ovarian carcinoma
Journal
International Journal of Environmental Research and Public Health
Journal Volume
16
Journal Issue
4
Date Issued
2019
Author(s)
Abstract
We aimed to determine prognostic factors of early stage (I/II) epithelial ovarian carcinoma (EOC) including clinicopathologic and chemotherapeutic regimens. Four hundred and thirty-seven women who underwent primary staging surgery with adjuvant chemotherapy between January 1, 2000 and December 31, 2010 were retrospectively reviewed and analyzed from two medical centers. The prognostic factors were determined from multivariate survival analyses using Cox regression models. The majority of women were diagnosed with stage Ic (244/437, 55.8%). The histopathologic types were clear cell (37.5%), endometrioid (27.2%), serous (14.0%), and mucinous (13.3%). Fifty-seven percent (249/437) of the women received taxane-based (platinum plus paclitaxel) regimens and 43.0% received non-taxane (platinum plus cyclophosphamide) regimens as frontline adjuvant chemotherapy. Clear cell tumors (adjusted Hazard ratio (aHR) 0.37, 95% confidence interval (CI) 0.21-0.73, p = 0.001) showed better 5-year disease-free survival (DFS) than serous tumors. Women diagnosed at FIGO (International Federation of Gynecology and Obstetrics) stage II (aHR 5.97, 95% CI = 2.47-14.39, p < 0.001), grade 3 tumor without clear cell (aHR 2.28, 95% CI = 1.02-5.07, p = 0.004) and who received 3-5 cycles of non-taxane regimens (aHR 3.29, 95% CI = 1.47-7.34, p = 0.004) had worse 5-year overall survival (OS). Clear cell histology treated with taxane-based regimens showed significantly higher 5-year DFS (91.2% vs. 82.0%, aHR = 0.45, 95% CI = 0.21-0.93, p = 0.043) and 5-year OS (93.5% vs. 79.0%, aHR = 0.30, 95% CI = 0.13-0.70, p = 0.005) than those treated with non-taxane-based regimens. We conclude that stage, tumor grade, and chemotherapeutic regimens/cycles are independent prognostic factors for early stage ovarian cancer. ? 2019 by the authors. Licensee MDPI, Basel, Switzerland.
Other Subjects
antineoplastic metal complex; cyclophosphamide; paclitaxel; cancer; carcinogen; disease treatment; histology; multivariate analysis; reproductive health; survival; adult; aged; Article; cancer adjuvant therapy; cancer classification; cancer grading; cancer prognosis; cancer staging; cancer surgery; cancer survival; cell differentiation; clear cell carcinoma; clinical feature; clinical outcome; controlled study; disease free survival; early cancer; early cancer diagnosis; endometrioid carcinoma; epithelial cancer cell line; female; histopathology; human; human tissue; major clinical study; multiple cycle treatment; ovary carcinoma; overall survival; retrospective study; survival rate; adjuvant chemotherapy; clinical trial; middle aged; multicenter study; ovary tumor; pathology; prognosis; proportional hazards model; Adult; Aged; Carcinoma, Ovarian Epithelial; Chemotherapy, Adjuvant; Female; Humans; Middle Aged; Neoplasm Staging; Ovarian Neoplasms; Prognosis; Proportional Hazards Models; Retrospective Studies
Type
journal article