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Gynecol Oncol. 2010 Mar;116(3):307-11. doi: 10.1016/j.ygyno.2009.10.074. Epub 2009 Nov 27.

Survival after recurrence in early-stage high-risk epithelial ovarian cancer: a Gynecologic Oncology Group study.

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  • 1Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, Division of Gynecologic Oncology, San Francisco School of Medicine, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA 94143-1702, USA. chanjohn@obgyn.ucsf.edu

Abstract

OBJECTIVE:

This study aimed to evaluate the clinical outcome of recurrent early-stage high-risk epithelial ovarian cancer patients.

METHODS:

Demographic and clinicopathological data were collected from women enrolled in GOG 157 who underwent surgical staging and had recurrent disease. Survival probability was estimated using Kaplan-Meier method, and hazard ratio of death was analyzed using Cox regression model.

RESULTS:

Of 74 women with recurrent early-stage high-risk ovarian cancer, the median age at recurrence was 63 years; 93% were White, 2.7% were Black, 2.7% were Asian, and 1.4% were Others. Fifty-eight percent had stage I, and the remainder had stage II disease. Clear cell, serous, endometrioid, mucinous, and other tumors consisted of 28.4%, 25.7%, 24.3%, 16.2%, and 5.4% of patients, respectively; in addition, 36.5% had ascites, 33.8% had positive cytology, and 43.2% had ruptured tumors. Fifty-eight percent underwent three cycles, and 42% had six cycles of adjuvant chemotherapy with paclitaxel and carboplatin. Recurrence was diagnosed clinically in 46% and radiographically in 54% of women. The median time from completion of primary chemotherapy to recurrence (treatment-free interval, TFI) was 21 months. Overall, median survival after recurrence was 24 months. Patients with longer (>24 months) TFI had a higher median survival after subsequent treatment at 35 months compared to only 10 months in those who recurred <or=24 months (p=0.003).

CONCLUSIONS:

Although patients with primary early-stage high-risk ovarian cancer have an overall favorable prognosis, survival after recurrence is poor and comparable to those with recurrent advanced-stage disease. Novel therapeutic modalities are warranted in these high-risk patients.

PMID:
19944452
[PubMed - indexed for MEDLINE]
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