TY - JOUR
T1 - Is stabilization of disease a useful indicator for survival in second-line treatment of ovarian carcinoma pre-treated with Paclitaxel-Platinum?
AU - Gronlund, Bo
AU - Høgdall, Claus
AU - Christensen, Ib J
AU - Engelholm, Svend A
AU - Hansen, Heine H
PY - 2004/8
Y1 - 2004/8
N2 - OBJECTIVE: Recurrent ovarian carcinoma is considered an incurable disease and second-line chemotherapy is administered for extension of survival and palliation. The impact of continued antineoplastic treatment in patients with stable disease without a demonstrable response is uncertain. The aim of this analysis was to assess the value of a stabilization of the tumor size in second-line chemotherapy as an indicator of survival.METHODS: Retrospective, single-institution study of 487 consecutive patients with primary epithelial ovarian carcinoma.INCLUSION CRITERIA: (1) FIGO stage IC-IV epithelial ovarian carcinoma; (2) first-line chemotherapy with Paclitaxel and a Platinum-compound; (3) refractory, persistent, or recurrent disease diagnosed by imaging methods; and (4) intravenous second-line chemotherapy with single Topotecan or Paclitaxel-Carboplatin. Univariate and multivariate analyses of survival with the World Health Organization (WHO) tumor response parameter included as a time-dependent variable were performed.RESULTS: The response rates were (N = 100): complete response (CR) 27%, partial response (PR) 14%, stable disease (SD) 41% and progressive disease (PD) 18%. In a multivariate Cox regression analysis of survival, SD was found to be an independent prognostic factor for survival and the death hazard ratio was 0.37 (SD versus PD; 95% CI: 0.16-0.86; P = 0.02). There was no statistically significant difference in survival between patients with PR and SD (P = 0.09).CONCLUSION: In second-line chemotherapy of ovarian cancer, patients demonstrating SD have a survival benefit compared to patients with PD measured by the WHO tumor response criteria.
AB - OBJECTIVE: Recurrent ovarian carcinoma is considered an incurable disease and second-line chemotherapy is administered for extension of survival and palliation. The impact of continued antineoplastic treatment in patients with stable disease without a demonstrable response is uncertain. The aim of this analysis was to assess the value of a stabilization of the tumor size in second-line chemotherapy as an indicator of survival.METHODS: Retrospective, single-institution study of 487 consecutive patients with primary epithelial ovarian carcinoma.INCLUSION CRITERIA: (1) FIGO stage IC-IV epithelial ovarian carcinoma; (2) first-line chemotherapy with Paclitaxel and a Platinum-compound; (3) refractory, persistent, or recurrent disease diagnosed by imaging methods; and (4) intravenous second-line chemotherapy with single Topotecan or Paclitaxel-Carboplatin. Univariate and multivariate analyses of survival with the World Health Organization (WHO) tumor response parameter included as a time-dependent variable were performed.RESULTS: The response rates were (N = 100): complete response (CR) 27%, partial response (PR) 14%, stable disease (SD) 41% and progressive disease (PD) 18%. In a multivariate Cox regression analysis of survival, SD was found to be an independent prognostic factor for survival and the death hazard ratio was 0.37 (SD versus PD; 95% CI: 0.16-0.86; P = 0.02). There was no statistically significant difference in survival between patients with PR and SD (P = 0.09).CONCLUSION: In second-line chemotherapy of ovarian cancer, patients demonstrating SD have a survival benefit compared to patients with PD measured by the WHO tumor response criteria.
KW - Aged
KW - Antineoplastic Agents/therapeutic use
KW - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
KW - Carboplatin/administration & dosage
KW - Cisplatin/administration & dosage
KW - Cohort Studies
KW - Female
KW - Humans
KW - Middle Aged
KW - Neoplasm Recurrence, Local/drug therapy
KW - Neoplasm Staging
KW - Ovarian Neoplasms/drug therapy
KW - Paclitaxel/administration & dosage
KW - Palliative Care/methods
KW - Prognosis
KW - Retrospective Studies
KW - Topotecan/therapeutic use
U2 - 10.1016/j.ygyno.2004.05.005
DO - 10.1016/j.ygyno.2004.05.005
M3 - Journal article
C2 - 15297181
SN - 0090-8258
VL - 94
SP - 409
EP - 415
JO - Gynecologic Oncology
JF - Gynecologic Oncology
IS - 2
ER -