Chemotherapy is not Necessary for Early-Stage Serous and Endometrioid Ovarian Cancer After Undergoing Comprehensive Staging Surgery
Abstract Background: To investigate whether adjuvant chemotherapy was essential for patients with early-stage serous and endometrioid epithelial ovarian cancer,we collected data from the US Surveillance, Epidemiology, and End Results database between 2004 and 2015. All subjects underwent comprehensive staging surgery and their pathological diagnoses were stage IA-IIA, grade 1-2. Ultimately, a total of 2,644 patients were enrolled in the study, among which 1,589 patients received platinum-based chemotherapy. Comparisons of categorical data were done by chi-square tests. Variables with P < 0.05 in univariate analysis were further analyzed using multiple logistic regression. Selection bias from the heterogeneity of demographic and clinical characteristics were avoided by propensity score matching. Cox proportional hazards models were applied to estimate hazard ratios (HR) and 95% confidence intervals (CI), exploring the relationship between variables and 5-year overall survival.Results: After propensity score matching, patients with or without chemotherapy were equal number (n=925). Our results indicated that 65 years of age or older increased the hazard and was related to poor prognostic (HR = 1.486, CI = 1.208- 1.827, P < 0.001). Endometrioid carcinoma was associated with better 5-year overall survival than serous cystadenocarcinoma (HR = 0.697, CI = 0.584-0.833, P < 0.001). Chemotherapy could not prolong 5-year overall survival of early-stage serous and endometrioid ovarian cancer patients (HR = 1.092, CI = 0.954-1.249, P = 0.201).Conclusions: These results demonstrated that adjuvant chemotherapy was unnecessary for patients with early-stage serous and endometrioid ovarian cancer after they underwent comprehensive staging surgery.