R Zang1, S Cai, Z Zhang. 1. Department of Gynecological Oncology, Cancer Hospital, Fudan University, Shanghai 200032, China.
Abstract
OBJECTIVE: To investigate the role of first-line chemotherapy in the management of advanced epithelial ovarian cancer (AEOC) and the effects on long-term survival epithelial. METHODS: From January 1986 to December 1997, 348 cases of stage III and IV epithelial ovarian cancer treated at our institute were reviewed retrospectively, and the patients were divided into optimal and suboptimal groups according to the size of residual disease after primary cytoreduction. Survival was calculated by Kaplan-Meier method with difference in survival estimated by Log-rank test. Long-term survival (5 years) determining factors were identified by Logistic regression model. RESULTS: The median age was 55 years (range, 20-82 years). In the optimal group, there was a significant difference in survival between patients with and without intraperitoneal chemotherapy, with an estimated median survival of 46 months and 36 months respectively (chi2 = 7.39, P = 0.0065). In the suboptimal group, the estimated median survival was 22 months in patients with more than 6 cycles of chemotherapy, 11 months in those less than 6 cycles (chi2 = 4.31, P = 0.0380). Neoadjuvant chemotherapy, tumor grade were independent prognostic factors of survival in this group. Size of residual disease, intraperitoneal chemotherapy, and tumor grade were determinants of long-term survival of AEOC. CONCLUSIONS: Multi-courses ( > 6) of platinum-based intravenous chemotherapy prolonged the survival of patients with suboptimal cytoreduction. Intraperitoneal chemotherapy was one of the dominant long-term survival determinants, and mainly on those with size of residual disease less than 1 cm.
OBJECTIVE: To investigate the role of first-line chemotherapy in the management of advanced epithelial ovarian cancer (AEOC) and the effects on long-term survival epithelial. METHODS: From January 1986 to December 1997, 348 cases of stage III and IV epithelial ovarian cancer treated at our institute were reviewed retrospectively, and the patients were divided into optimal and suboptimal groups according to the size of residual disease after primary cytoreduction. Survival was calculated by Kaplan-Meier method with difference in survival estimated by Log-rank test. Long-term survival (5 years) determining factors were identified by Logistic regression model. RESULTS: The median age was 55 years (range, 20-82 years). In the optimal group, there was a significant difference in survival between patients with and without intraperitoneal chemotherapy, with an estimated median survival of 46 months and 36 months respectively (chi2 = 7.39, P = 0.0065). In the suboptimal group, the estimated median survival was 22 months in patients with more than 6 cycles of chemotherapy, 11 months in those less than 6 cycles (chi2 = 4.31, P = 0.0380). Neoadjuvant chemotherapy, tumor grade were independent prognostic factors of survival in this group. Size of residual disease, intraperitoneal chemotherapy, and tumor grade were determinants of long-term survival of AEOC. CONCLUSIONS: Multi-courses ( > 6) of platinum-based intravenous chemotherapy prolonged the survival of patients with suboptimal cytoreduction. Intraperitoneal chemotherapy was one of the dominant long-term survival determinants, and mainly on those with size of residual disease less than 1 cm.