The Impact of Time Between Ovarian Cancer Treatments

Researchers have been looking into how they can best alter chemotherapy treatments for the highest efficacy possible; however, in doing so, they found that the length of time a patient takes between completing neoadjuvant chemotherapy and beginning postoperative adjuvant chemotherapy can directly impact their chances of surviving advanced ovarian cancer.

Procedure times

Many patients go into postoperative adjuvant chemotherapy some time after they have completed their neoadjuvant chemotherapy; however, if they enter into it within 42 days of completion, they have shown to have a significantly heightened chance of surviving, even with an advanced stage of ovarian cancer.

Limitations

It was considered a limitation of the study that it was both acknowledging medical records, and retrospective in general. Also, all of the patients were treated in one facility, which stopped the study from having as broad of a reach.

Also, the study was unable to gain insight into the physical status of patients, which may alter results in some cases, as it determines initiation of surgery and chemotherapy.

The study also focused on mortality regardless of the cause, instead of only analyzing deaths that specifically occurred due to cancer. Of course, distinguishing between the two in these circumstances is often difficult, as the causes influence one another with complications or comorbidities.

The study

At Yonsei Cancer Hospital in Seoul, these women had received neoadjuvant chemotherapy between the years of 2006 and 2016. Researchers' multivariate analysis showed a longer interval between treatments depicted a dramatic decreases in the potential of surviving without progression, as well as survival in general (hazard ratio, 1.41; 95% CI, 0.98-2.03 and 2.03; 95% CI, 1.16-3.53, respectively).

The researchers stated that the time interval was the period of time between the two forms of chemotherapy, and included debulking surgery, or IDS.

Participants

Each of the patients involved in the study had confirmed stage III or IV ovarian cancer before the beginning of their experiences with chemotherapy. While the ages of the participants ranged from 31 to 78, the median age was 57.

The majority of the participants, around 91 percent, had serious histology. Nearly half, 42 percent, experienced radical surgery (including the fifteen percent who had bowel surgery). For nearly half of the participants (44 percent), after undergoing IDS, they did not suffer from a gross residual tumor.

Chemotherapy

Each of the patients involved in the study had a platinum-based combination chemotherapy. Most of the patients (155, to be exact) received carboplatin combined with paclitaxel. Most of the participants had to undergo around eight cycles of chemotherapy, although there was a range between four and twelve.

The study then ensured that around half of the patients would begin their treatment within 42 days of completing their neoadjuvant chemotherapy, while the other group would wait until after that marker.

While the two groups were experiencing different lengths between their chemotherapy treatments, they were divided nearly evenly, with no significant differences in identifying factors such as BMI, ASA, baseline of CA-125, age, histology, FIGO stage, surgeries, complications, differing chemotherapy regimens, chemotherapy cycles, or residual diseases.

Read on to learn more about this discovery.