Background
Methods
Study population
Data collection
Statistical analysis
Results
Analysis in all patients
Characteristics | All (n = 135) | Extended chemotherapy (n = 52) | Standard chemotherapy (n = 83) | P |
---|---|---|---|---|
Age at initial diagnosis, years | 55.5 ± 10.1 | 55.0 ± 9.0 | 55.9 ± 10.7 | 0.624 |
Age at 1st recurrence, years | 57.4 ± 9.9 | 56.6 ± 9.1 | 57.9 ± 10.4 | 0.475 |
Primary site of disease | 0.314 | |||
Ovary | 123 (91.1) | 46 (88.5) | 77 (92.8) | |
Tube | 4 (3.0) | 1 (1.9) | 3 (3.6) | |
Peritoneum | 8 (5.9) | 5 (9.6) | 3 (3.6) | |
Histologic type | 0.344 | |||
Serous | 120 (88.9) | 46 (88.5) | 74 (89.2) | |
Endometrioid | 8 (5.9) | 3 (5.8) | 5 (6.0) | |
Mucinous | 1 (0.7) | 1 (1.9) | 0 | |
Clear cell | 3 (2.2) | 2 (3.8) | 1 (1.2) | |
Mixed | 3 (2.2) | 0 | 3 (3.6) | |
Grade | 0.136 | |||
1 | 4 (3.0) | 3 (5.8) | 1 (1.2) | |
2 | 7 (5.2) | 1 (1.9) | 6 (7.2) | |
3 | 124 (91.9) | 48 (92.3) | 76 (91.6) | |
FIGO stage | 0.496 | |||
I-II | 9 (6.7) | 5 (9.6) | 4 (4.8) | |
III | 88 (65.2) | 34 (65.4) | 54 (6.1) | |
IV | 38 (28.1) | 13 (25.0) | 25 (30.1) | |
Primary treatment strategy | 0.540 | |||
PDS | 100 (74.1) | 37 (71.2) | 63 (75.9) | |
NAC | 35 (25.9) | 15 (28.8) | 20 (24.1) | |
Results of initial debulking surgery | 0.041 | |||
Complete gross resection | 72 (53.3) | 22 (42.3) | 50 (60.2) | |
Residual tumor <1 cm | 36 (26.7) | 20 (38.5) | 16 (19.3) | |
Residual tumor ≥1 cm | 27 (20.0) | 10 (19.2) | 17 (20.5) | |
Platinum-free interval, months | ||||
Median (range) | 12.5 (6.0–87.9) | 11.0 (6.2–87.9) | 13.1 (6.0–84.5) | 0.018 |
6–12, partially platinum-sensitive | 61 (45.2) | 28 (53.8) | 33 (39.8) | 0.109 |
≥12, totally platinum-sensitive | 74 (54.8) | 24 (46.2) | 50 (60.2) | |
CA-125 at 1st recurrence, IU/mL | 0.152 | |||
Median (range) | 91.0 (7.9–6290.0) | 99.1 (12.0–6290.0) | 91.0 (7.9–1908.0) | |
Secondary debulking surgery | 0.003 | |||
No | 118 (87.4) | 51 (98.1) | 67 (80.7) | |
Yes | 17 (12.6) | 1 (1.9) | 16 (19.3) | |
Results of secondary debulking surgery | 0.279 | |||
Complete gross resection | 6 (4.4) | 0 | 6 (7.2) | |
Residual tumor <1 cm | 6 (4.4) | 0 | 6 (7.2) | |
Residual tumor ≥1 cm | 5 (3.7) | 1 (1.9) | 4 (4.8) | |
Residual tumor on CT after #6 | 0.232 | |||
≥0.5 cm and <1 cm | 65 (48.1) | 28 (53.8) | 37 (44.6) | |
≥1 cm and <2 cm | 56 (41.5) | 17 (32.7) | 39 (47.0) | |
≥2 cm | 14 (10.4) | 7 (13.5) | 7 (8.4) | |
CA-125 after #6, IU/mL | 0.122 | |||
Median (range) | 12.5 (1.1–445.0) | 14.0 (1.1–249.0) | 11.0 (1.1–445.0) | |
Maintenance therapy | ||||
No | 98 (72.6) | 46 (88.5) | 52 (62.7) | 0.001 |
Yes | 37 (27.4) | 6 (11.5) | 31 (37.3) | |
Bevacizumab | 29 (21.5) | 5 (9.6) | 24 (28.9) | >0.999 |
Olaparib | 8 (5.9) | 1 (1.9) | 7 (8.4) | |
Germline BRCA1/2 gene test | ||||
Not performed | 51 (37.8) | 23 (44.2) | 28 (33.7) | 0.221 |
Performed | 84 (62.2) | 29 (55.8) | 55 (66.3) | |
Wild-type | 58 (43.0) | 21 (40.4) | 37 (44.6) | 0.628 |
Mutation | 26 (19.3) | 8 (15.4) | 18 (21.7) |
Characteristics | Progression-free survival | Overall survival | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Univariate analysis | Multivariate analysis | Univariate analysis | Multivariate analysis | |||||||
HR | 95% CI | aHR | 95% CI | P | HR | 95% CI | aHR | 95% CI | P | |
Age at initial diagnosis, years | ||||||||||
≥55 vs. <55 | 0.83 | 0.57–1.19 | 0.75 | 0.51–1.08 | 0.122 | 0.96 | 0.51–1.78 | |||
Histologic type | ||||||||||
Non-HGSC vs. HGSC | 1.10 | 0.64–1.90 | 0.80 | 0.29–2.26 | ||||||
FIGO stage | ||||||||||
IV vs. I-III | 1.15 | 0.77–1.71 | 0.81 | 0.53–1.22 | 0.308 | 0.98 | 0.48–2.00 | 0.78 | 0.37–1.66 | 0.515 |
Primary treatment strategy | ||||||||||
NAC vs. PDS | 0.92 | 0.60–1.39 | 2.28 | 1.20–4.34 | ||||||
Results of initial debulking surgery | ||||||||||
Residual tumor vs. CGR | 1.16 | 0.81–1.66 | 1.26 | 0.68–2.36 | ||||||
Platinum-free interval, months | ||||||||||
≥12 vs. 6–12 | 0.46 | 0.31–0.66 | 0.42 | 0.29–0.63 | <0.001 | 0.36 | 0.19–0.67 | 0.37 | 0.19–0.70 | 0.003 |
CA-125 at 1st recurrence, IU/mL | ||||||||||
≥90 vs. <90 | 1.76 | 1.22–2.53 | 2.21 | 1.50–3.25 | <0.001 | 1.92 | 1.02–3.60 | 1.90 | 1.00–3.60 | 0.050 |
Secondary debulking surgery | ||||||||||
Yes vs. No | 0.67 | 0.37–1.22 | 0.88 | 0.27–2.88 | ||||||
Residual tumor on CT after #6 | ||||||||||
≥1 cm vs. <1 cm | 1.09 | 0.76–1.56 | 1.20 | 0.83–1.74 | 0.326 | 2.01 | 1.04–3.90 | 2.38 | 1.20–4.71 | 0.013 |
CA-125 after #6, IU/mL | ||||||||||
≥12.5 vs. <12.5 | 1.50 | 1.04–2.15 | 1.47 | 0.79–2.73 | ||||||
Maintenance therapy | ||||||||||
Yes vs. No | 0.50 | 0.32–0.76 | 0.44 | 0.28–0.69 | <0.001 | 0.67 | 0.30–1.53 | 0.65 | 0.28–1.52 | 0.317 |
Extended chemotherapy | ||||||||||
Yes vs. No | 1.61 | 1.11–2.34 | 1.25 | 0.84–1.85 | 0.279 | 1.32 | 0.71–2.44 | 1.36 | 0.72–2.56 | 0.342 |
Analysis in patients who did not receive secondary debulking surgery
Characteristics | All (n = 118) | Extended chemotherapy (n = 51) | Standard chemotherapy (n = 67) | P |
---|---|---|---|---|
Age at initial diagnosis, years | 56.1 ± 10.0 | 54.8 ± 9.0 | 57.1 ± 10.6 | 0.208 |
Age at 1st recurrence, years | 57.9 ± 9.9 | 56.4 ± 9.0 | 59.0 ± 10.5 | 0.159 |
Primary site of disease | 0.499 | |||
Ovary | 107 (90.7) | 45 (88.2) | 62 (92.5) | |
Tube | 3 (2.5) | 1 (2.0) | 2 (3.0) | |
Peritoneum | 8 (6.8) | 5 (9.8) | 3 (4.5) | |
Histologic type | 0.381 | |||
Serous | 106 (89.8) | 46 (90.2) | 60 (89.6) | |
Endometrioid | 6 (5.1) | 3 (5.9) | 3 (4.5) | |
Mucinous | 3 (2.5) | 2 (3.9) | 1 (1.5) | |
Clear cell | 3 (2.5) | 0 | 3 (4.5) | |
Mixed | ||||
Grade | 0.113 | |||
1 | 2 (1.7) | 2 (3.9) | 0 | |
2 | 6 (5.1) | 1 (2.0) | 5 (7.5) | |
3 | 110 (93.2) | 48 (94.1) | 62 (92.5) | |
FIGO stage | 0.686 | |||
I-II | 7 (5.9) | 4 (7.8) | 3 (4.5) | |
III | 78 (66.1) | 34 (66.7) | 44 (65.7) | |
IV | 33 (28.0) | 13 (25.5) | 20 (29.9) | |
Primary treatment strategy | 0.625 | |||
PDS | 86 (72.9) | 36 (70.6) | 50 (74.6) | |
NAC | 32 (27.1) | 15 (29.4) | 17 (25.4) | |
Results of initial debulking surgery | 0.036 | |||
Complete gross resection | 59 (50.0) | 21 (41.2) | 38 (56.7) | |
Residual tumor <1 cm | 32 (27.1) | 20 (39.2) | 12 (17.9) | |
Residual tumor ≥1 cm | 27 (22.9) | 10 (19.6) | 17 (25.4) | |
Platinum-free interval, months | ||||
Median (range) | 12.2 (6.0–87.9) | 11.0 (6.2–87.9) | 12.7 (6.0–57.8) | 0.059 |
6–12, partially platinum-sensitive | 55 (46.6) | 27 (52.9) | 28 (41.8) | 0.229 |
≥12, totally platinum-sensitive | 63 (53.4) | 24 (47.1) | 39 (58.2) | |
CA-125 at 1st recurrence, IU/mL | 0.145 | |||
Median (range) | 93.3 (7.9–6290.0) | 107.9 (12.0–6290.0) | 92.9 (7.9–1908.0) | |
Residual tumor on CT after #6 | 0.446 | |||
≥0.5 cm and <1 cm | 57 (48.3) | 27 (52.9) | 30 (44.8) | |
≥1 cm and <2 cm | 47 (39.8) | 17 (33.3) | 30 (44.8) | |
≥2 cm | 14 (11.9) | 7 (13.7) | 7 (10.4) | |
CA-125 after #6, IU/mL | 0.087 | |||
Median (range) | 12.7 (1.1–289.7) | 14.0 (1.1–249.0) | 11.0 (1.1–289.7) | |
Maintenance therapy | ||||
No | 90 (76.3) | 45 (88.2) | 45 (67.2) | 0.008 |
Yes | 28 (23.7) | 6 (11.8) | 22 (32.8) | |
Bevacizumab | 23 (19.5) | 5 (9.8) | 18 (26.9) | >0.999 |
Olaparib | 5 (4.2) | 1 (2.0) | 4 (6.0) | |
Germline BRCA1/2 gene test | ||||
Not performed | 49 (41.5) | 23 (45.1) | 26 (38.8) | 0.492 |
Performed | 69 (58.5) | 28 (54.9) | 41 (61.2) | |
Wild-type | 47 (39.8) | 20 (39.2) | 27 (40.3) | 0.626 |
Mutation | 22 (18.6) | 8 (15.7) | 14 (20.9) |
Characteristics | Progression-free survival | Overall survival | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Univariate analysis | Multivariate analysis | Univariate analysis | Multivariate analysis | |||||||
HR | 95% CI | aHR | 95% CI | P | HR | 95% CI | aHR | 95% CI | P | |
Age at initial diagnosis, years | ||||||||||
≥55 vs. <55 | 0.75 | 0.51–1.11 | 0.714 | 0.483–1.057 | 0.093 | 0.80 | 0.42–1.54 | |||
Histologic type | ||||||||||
Non-HGSC vs. HGSC | 1.01 | 0.54–1.91 | 0.75 | 0.23–2.45 | ||||||
FIGO stage | ||||||||||
IV vs. I-III | 1.14 | 0.74–1.73 | 0.94 | 0.44–2.00 | 0.74 | 0.33–1.64 | 0.461 | |||
Primary treatment strategy | ||||||||||
NAC vs. PDS | 1.13 | 0.74–1.74 | 2.48 | 1.28–4.79 | ||||||
Results of initial debulking surgery | ||||||||||
Residual tumor vs. CGR | 1.15 | 0.79–1.68 | 1.22 | 0.63–2.34 | ||||||
Platinum-free interval, months | ||||||||||
≥12 vs. 6–12 | 0.44 | 0.29–0.65 | 0.40 | 0.27–0.61 | <0.001 | 0.37 | 0.19–0.71 | 0.37 | 0.19–0.72 | 0.004 |
CA-125 at 1st recurrence, IU/mL | ||||||||||
≥90 vs. <90 | 1.60 | 1.09–2.35 | 1.88 | 1.26–2.82 | 0.002 | 1.77 | 0.92–3.42 | 1.78 | 0.91–3.47 | 0.090 |
Residual tumor on CT after #6 | ||||||||||
≥1 cm vs. <1cm | 1.12 | 0.76–1.63 | 1.23 | 0.84–1.81 | 0.294 | 1.79 | 0.91–3.52 | 2.10 | 1.05–4.22 | 0.036 |
CA-125 after #6, IU/mL | ||||||||||
≥12.5 vs. <12.5 | 1.58 | 1.08–2.32 | 1.18 | 0.79–1.76 | 0.412 | 1.36 | 0.72–2.58 | |||
Maintenance therapy | ||||||||||
Yes vs. No | 0.48 | 0.30–0.77 | 0.44 | 0.26–0.72 | 0.001 | 0.69 | 0.29–1.66 | 0.71 | 0.29–1.76 | 0.456 |
Extended chemotherapy | ||||||||||
Yes vs. No | 1.51 | 1.02–2.24 | 1.18 | 0.78–1.78 | 0.428 | 1.32 | 0.70–2.51 | 1.42 | 0.74–2.73 | 0.297 |