Variations in adjuvant chemotherapy and survival in women with epithelial ovarian cancer – a population-based study

Anuradha, Satyamurthy, Donovan, Peter J., Webb, Penelope, Brand, Alison H., Goh, Jeffrey, Friedlander, Michael, Oehler, Martin K., Quinn, Michael, Steer, Christopher and Jordan, Susan J. (2015) Variations in adjuvant chemotherapy and survival in women with epithelial ovarian cancer – a population-based study. Acta Oncologica, 55 2: 226-233. doi:10.3109/0284186X.2015.1054950


Author Anuradha, Satyamurthy
Donovan, Peter J.
Webb, Penelope
Brand, Alison H.
Goh, Jeffrey
Friedlander, Michael
Oehler, Martin K.
Quinn, Michael
Steer, Christopher
Jordan, Susan J.
Title Variations in adjuvant chemotherapy and survival in women with epithelial ovarian cancer – a population-based study
Journal name Acta Oncologica   Check publisher's open access policy
ISSN 0284-186X
1651-226X
Publication date 2015-06-14
Sub-type Article (original research)
DOI 10.3109/0284186X.2015.1054950
Open Access Status Not yet assessed
Volume 55
Issue 2
Start page 226
End page 233
Total pages 8
Place of publication London, United Kingdom
Publisher Informa Healthcare
Language eng
Subject 2720 Hematology
2730 Oncology
2741 Radiology Nuclear Medicine and imaging
Abstract Background. To investigate whether variations in primary chemotherapy were associated with survival in a nationally complete cohort of Australian women with epithelial ovarian cancer (EOC). Material and methods. All 1192 women diagnosed with invasive EOC in Australia in 2005 were identified through state-based cancer registries. Medical record information including details of primary chemotherapy treatment was obtained and survival data updated in 2012. Those started on standard chemotherapy (carboplatin and paclitaxel given at three-weekly intervals) after primary cytoreductive surgery were included (n = 351) and the relative dose intensity (RDI) was calculated. Time interval between surgery and start of chemotherapy was analysed in weeks. Hazard ratios [HR, 95% confidence interval (CI)] were calculated using multivariable Cox proportional hazards models. Results. Compared to women with RDI of 91-100%, those with RDI of ≤ 70% had significantly poor survival (HR = 1.62, 95% CI 1.05-2.49). This association was stronger among women with advanced (FIGO stage III/IV) disease at diagnosis (HR = 1.90, 95% CI 1.22-2.96). The interval between primary surgery and chemotherapy was not related to survival (HR = 0.98, 95% CI 0.93-1.03 for every week of delay), at least up to a period of five weeks. Conclusion. Our results suggest that RDI of 70% or less was associated with poorer survival, particularly in women with advanced stage EOC. In contrast, the interval duration between primary surgery and chemotherapy was not related to survival, irrespective of disease stage or residual disease. These results provide some reassurance that, at least up until five weeks post-surgery, timing of chemotherapy commencement has a negligible effect on survival.
Formatted abstract
Background: To investigate whether variations in primary chemotherapy were associated with survival in a nationally complete cohort of Australian women with epithelial ovarian cancer (EOC).

Material and methods: All 1192 women diagnosed with invasive EOC in Australia in 2005 were identified through state-based cancer registries. Medical record information including details of primary chemotherapy treatment was obtained and survival data updated in 2012. Those started on standard chemotherapy (carboplatin and paclitaxel given at three-weekly intervals) after primary cytoreductive surgery were included (n = 351) and the relative dose intensity (RDI) was calculated. Time interval between surgery and start of chemotherapy was analysed in weeks. Hazard ratios [HR, 95% confidence interval (CI)] were calculated using multivariable Cox proportional hazards models.

Results: Compared to women with RDI of 91–100%, those with RDI of ≤ 70% had significantly poor survival (HRadj = 1.62, 95% CI 1.05–2.49). This association was stronger among women with advanced (FIGO stage III/IV) disease at diagnosis (HRadj = 1.90, 95% CI 1.22–2.96). The interval between primary surgery and chemotherapy was not related to survival (HRadj = 0.98, 95% CI 0.93–1.03 for every week of delay), at least up to a period of five weeks.

Conclusion: Our results suggest that RDI of 70% or less was associated with poorer survival, particularly in women with advanced stage EOC. In contrast, the interval duration between primary surgery and chemotherapy was not related to survival, irrespective of disease stage or residual disease. These results provide some reassurance that, at least up until five weeks post-surgery, timing of chemotherapy commencement has a negligible effect on survival.
Q-Index Code C1
Q-Index Status Confirmed Code
Grant ID 400281
400413
Institutional Status UQ
Additional Notes Early online

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Public Health Publications
 
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Created: Tue, 04 Aug 2015, 00:58:56 EST by Satyamurthy Anuradha on behalf of School of Public Health