RECIST 1.1 criteria predict recurrence-free survival in advanced ovarian cancer submitted to neoadjuvant chemotherapy

2019 ◽  
Vol 237 ◽  
pp. 93-99 ◽  
Author(s):  
Giorgio Bogani ◽  
Laura Matteucci ◽  
Stefano Tamberi ◽  
Antonino Ditto ◽  
Ilaria Sabatucci ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Ovarian Cancer ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Recist 1.1

scholarly journals Advanced stage ovarian cancer patients with neoadjuvant chemotherapy suffered worse recurrence free survival

2020 ◽  
Author(s):  
Cailiang Wu ◽  
Xuexin Zhou ◽  
Yiwen Feng ◽  
Yi Miao ◽  
Ye Yang ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Recurrence Free Survival ◽  
Advanced Stage ◽  
Debulking Surgery ◽  
Fallopian Tube Cancer ◽  
Free Survival ◽  
Primary Peritoneal Cancer ◽  
Peritoneal Cancer ◽  
Primary Debulking Surgery

Abstract Background Neoadjuvant chemotherapy (NACT) has been applied for the treatment of patients with advanced-stage epithelial ovarian cancer (EOC), fallopian tube cancer, and primary peritoneal cancer, as these patients have a low likelihood of achieving optimal debulking and are thus poor surgical candidates. Herein, we explore the effects of NACT and compare the surgical outcomes and recurrence data in patients who receive interval debulking surgery followed NACT(NACT-IDS) or primary debulking surgery(PDS). Methods A retrospective, single-center, observational study was conducted. Patients with advanced-stage EOC, fallopian tube cancer and primary peritoneal cancer who were treated with NACT or primary debulking surgery were enrolled. The effects of NACT as well as the surgical outcomes and recurrence data were compared between the NACT-IDS and PDS groups. Results The albumin level was elevated (42.61±3.46 g/L vs. 37.47±5.42 g/L, P=0.001) and the levels of CA12-5 and HE4 significantly decreased (P=0.002, 0.003) in patients after neoadjuvant courses. The operation time, amount of blood loss during surgery, rate of bowel resection, time to chemotherapy, and platinum-free interval were comparable between the two groups (P＞0.05). Recurrence-free survival was worse in the NACT-IDS group than in the PDS group (HR=2.406, 95% CI[1.024, 5.657]). Conclusion NACT improved the condition of advanced-stage patients, but a poor recurrence free survival rate was observed; thus, NACT should not be applied in non-selected patients.

Effect of metformin on recurrence-free survival and overall survival in diabetic patients affected by advanced ovarian cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 5522-5522 ◽  
Author(s):  
Cecilia Simonelli ◽  
Monica Bertolotti ◽  
Paul Sabbatini ◽  
Jonathan S. Berek ◽  
Jacobus Pfisterer ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Proportional Hazards Model ◽  
Advanced Ovarian Cancer ◽  
Cox Proportional Hazards Model ◽  
Diabetic Patients ◽  
Recurrence Free Survival ◽  
Double Blind ◽  
Free Survival

5522^ Background: Metformin, has recently shown some anti-cancer activities in ovarian cancer, both in vitro and in vivo. Methods: Analysis of Recurrence Free Survival (RFS) and Overall Survival (OS) was performed in patients (pts) with diabetes (D) treated with metformin (DMet+) or not (DMet-) enrolled in the MIMOSA trial, a randomized double-blind placebo-controlled international trial of Abagovomab maintenance therapy in 888 pts with advanced ovarian cancer. In the MIMOSA trial, no differences in the RFS and OS were observed between Abagovomab (n = 593) and Placebo arm (n = 295); hence, the present RFS and OS analysis (DMet+ vs DMet-) was run regardless of treatment allocation. A Cox proportional hazards model was used for adjusting the analysis for the predefined prognostic factors: Figo stage (III, IV), tumor size after debulking (residual tumor <1 cm, >1cm); CA125 serum level after 3th cycle (<35U/ml, >35U/ml). In addition, comparison of RFS and OS was done between DMet+and the overall MIMOSA population not exposed to metformin (ALLMet-), and between the overall diabetic pts (ALLD+) and non-diabetic pts (ALLD-). Results: In the ALL population (n = 888), 42 pts were affected by diabetes (ALLD+) divided to DMet+ (n = 27) and DMet- (n = 15), without difference in the prognostic factors distribution. When analysis was done in ALLD+, RFS median time was not reached in the DMet+ group whereas it was 328 days [CI: 30-660] in DMet- group with HR favoring DMet+=0.419 [CI:0.175-1.002]; p = 0.05. Median OS time was also not reached in the DMet+ group whereas it was 786 days [CI:262-NE] in DMet- group with HR=0.295 [CI:0.109-0.803]; p = 0.02. Interestingly HR for RFS time was still in favour of DMet+ group when compared to the ALLMet- (n=861) with HR=0.575 (CI=0.324-1.022); p = 0.06. When ALLD+ were compared with ALLD-(n = 846), no significant differences was detected in RFS and OS time. Conclusions: The present results are the first prospectively analyzed data demonstrating a favourable impact of metformin treatment on RFS and OS in pts affected by advanced ovarian cancer. Clinical trial information: NCT00418574.

PREDICTORS OF CHEMORESISTANCE TO PLATINUM-CONTAINING NEOADJUVANT CHEMOTHERAPY IN ADVANCED OVARIAN CANCER

2019 ◽  
Vol 65 (3) ◽  
pp. 422-426
Author(s):  
Dinara Dolgova ◽  
Snezhanna Gening ◽  
Tatyana Abakumova ◽  
Inna Antoneeva ◽  
Tatyana Gening ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Primary Tumor ◽  
Tumor Tissue ◽  
Advanced Ovarian Cancer ◽  
Complete Response ◽  
Free Survival ◽  
Kaplan Meier ◽  
Relationship Of ◽  
The Relationship

Chemoresistance is one of the main causes of treatment failure in advanced ovarian cancer (OC). In order to identify predictors of chemoresistance, 30 patients with ascitic form of OC, who received neoadjuvant chemotherapy (NACT) according to AP regimen, were examined. In the epithelial cells of ascites and in tumor tissue after NACT, expression of the VEGFa, ABCB1 and ERCC1 genes was assessed by PCR-RT. The effectiveness of NACT was assessed using the criteria of therapeutic pathomorphosis, survival - using the Kaplan-Meier criterion, the relationship of clinical and molecular parameters - using the Mann-Whitney criterion. Results. We established that in 43% of patients the response to NACT was absent (CRS1), the significant response (CRS2) was in 35% of cases, and the complete response (CRS3) was in 21% of cases. VEGFa expression was increased in ascites in 17% of cases, in tumor tissue - in 33% in the CRS1 group. In groups with CRS 2,3, overexpression of VEGFa in ascites was detected in 25% of cases, in tumor tissue in 37.5%. ABCB1 mRNA expression was increased after NACT in 50% of cases in the CRS1 group and in 25% of cases in the CRS 2,3 group. Thus, platinum-based NACT initiates an increase in the expression of VEGFa and ABCB1 in tumor tissue. We established that in case of high expression (ERCC + / VEGF + / ABCB1 +) in ascites, there is a statistically significant increase in relapse-free survival compared with the group with low or absent expression (p = 0.012). The overall survival rate was 41.8 months in patients with overexpression of the studied genes in the tissue of the primary tumor after NACT and 25.3 months in patients with low expression (p = 0.058). Conclusion. The levels of ERCC1, VEGFa and ABCB1 mRNA in ascitic cells before NACT and in the primary tumor after NACT according to the AP scheme can serve as a predictor of the effectiveness of this treatment in ascitic OC.

The Effects of Anemia and Blood Transfusion on Patients With Stage III-IV Ovarian Cancer

2013 ◽  
Vol 23 (9) ◽  
pp. 1569-1576 ◽  
Author(s):  
Alon D. Altman ◽  
Xiao-Qing Liu ◽  
Gregg Nelson ◽  
Pamela Chu ◽  
Jill Nation ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Blood Transfusion ◽  
Advanced Ovarian Cancer ◽  
Retrospective Chart Review ◽  
Continuous Variable ◽  
Blood Transfusions ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Estimated Blood Loss

ObjectivesThe objective of this study was to examine the overall and recurrence-free survival in patients with advanced ovarian cancer based on hemoglobin and blood transfusions.MethodsA retrospective chart review was performed between 2003 and 2007 on patients with pathologically confirmed stage 3–4 ovarian, fallopian, or peritoneal cancers. Data were collected on date of diagnosis, recurrence and death, stage, grade, age, surgery, estimated blood loss, hemoglobin (nadir and average levels), and number of blood transfusions.ResultsTwo hundred sixteen patients were included in the final analysis. In the perichemotherapy, perioperative, and total time frames, 88%, 81%, and 95% of patients were anemic, and 9%, 22%, and 26% of the patients had severe anemia. After adjusting for age, stage, and optimal debulking status, the perichemotherapy hemoglobin level as a continuous variable was weakly associated with recurrence-free survival (adjusted hazard ratio [AHR], 0.98;P= 0.03), and as a categorical variable with both recurrence-free survival (AHR, 2.49;P= 0.003) and overall survival (AHR, 1.91;P= 0.02). The total number of transfusions was also weakly associated with poor recurrence-free survival (AHR, 1.06;P= 0.03).ConclusionsOur study is a retrospective analysis of the effects of anemia and transfusion on ovarian cancer. The rates of anemia in chemotherapy patients are higher than previously reported. Although maintaining average hemoglobin greater than 80 g/L during chemotherapy portends an improved overall survival, blood transfusion does not have any effect. The role of transfusion should therefore be limited to symptomatic patients while giving 1 unit at a time. Further prospective studies will be needed to confirm these results.

scholarly journals Does Time-to-Chemotherapy after Primary Complete Macroscopic Cytoreductive Surgery Influence Prognosis for Patients with Epithelial Ovarian Cancer? A Study of the FRANCOGYN Group

2021 ◽  
Vol 10 (5) ◽  
pp. 1058
Author(s):  
Grégoire Rocher ◽  
Thomas Gaillard ◽  
Catherine Uzan ◽  
Pierre Collinet ◽  
Pierre-Adrien Bolze ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Cytoreductive Surgery ◽  
Retrospective Cohort ◽  
Early Stage ◽  
Cohort Analysis ◽  
Recurrence Free Survival ◽  
Advanced Stage ◽  
Free Survival ◽  
Retrospective Cohort Analysis

To determine if the time-to-chemotherapy (TTC) after primary macroscopic complete cytoreductive surgery (CRS) influences recurrence-free survival (RFS) and overall survival (OS) in patients with epithelial ovarian cancer (EOC). We conducted an observational multicenter retrospective cohort analysis of women with EOC treated from September 2006 to November 2016 in nine institutions in France (FRANCOGYN research group) with maintained EOC databases. We included women with EOC (all FIGO stages) who underwent primary complete macroscopic CRS prior to platinum-based adjuvant chemotherapy. Two hundred thirty-three patients were included: 73 (31.3%) in the early-stage group (ESG) (FIGO I-II), and 160 (68.7%) in the advanced-stage group (ASG) (FIGO III-IV). Median TTC was 43 days (36–56). The median OS was 77.2 months (65.9–106.6). OS was lower in the ASG when TTC exceeded 8 weeks (70.5 vs. 59.3 months, p = 0.04). No impact on OS was found when TTC was below or above 6 weeks (78.5 and 66.8 months, respectively, p = 0.25). In the whole population, TTC had no impact on RFS or OS. None of the factors studied were associated with an increase in TTC. Chemotherapy should be initiated as soon as possible after CRS. A TTC greater than 8 weeks is associated with poorer OS in patients with advanced stage EOC.

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