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Impact of the time interval from completion of neoadjuvant chemotherapy to initiation of postoperative adjuvant chemotherapy on the survival of patients with advanced ovarian cancer.

Authors
 Yong Jae Lee  ;  Young Shin Chung  ;  Jung-Yun Lee  ;  Eun Ji Nam  ;  Sang Wun Kim  ;  Sunghoon Kim  ;  Young Tae Kim 
Citation
 Gynecologic Oncology, Vol.148(1) : 62-67, 2018 
Journal Title
 Gynecologic Oncology 
ISSN
 0090-8258 
Issue Date
2018
MeSH
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/administration & dosage* ; Chemotherapy, Adjuvant ; Drug Administration Schedule ; Female ; Humans ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Staging ; Neoplasms, Glandular and Epithelial/drug therapy* ; Neoplasms, Glandular and Epithelial/mortality ; Neoplasms, Glandular and Epithelial/pathology ; Neoplasms, Glandular and Epithelial/surgery ; Ovarian Neoplasms/drug therapy* ; Ovarian Neoplasms/mortality ; Ovarian Neoplasms/pathology ; Ovarian Neoplasms/surgery ; Postoperative Care ; Retrospective Studies
Keywords
Adjuvant chemotherapy ; Interval debulking surgery ; Neoadjuvant chemotherapy ; Ovarian cancer ; Survival ; Time interval
Abstract
OBJECTIVE: To investigate the relationship of the time interval from the completion of neoadjuvant chemotherapy (NAC) to the initiation of postoperative adjuvant chemotherapy (POAC) with the survival outcomes in patients with ovarian cancer. METHODS: We retrospectively investigated 220 patients with pathologically confirmed epithelial ovarian cancer who received NAC at Yonsei Cancer Hospital between 2006 and 2016. The time interval was defined as the period from the completion of NAC, spanning interval debulking surgery (IDS), to the initiation of POAC. RESULTS: The median time interval was 42 (range 16-178) days; 103 patients (53.1%) received POAC within 42days after NAC while 91 patients (46.9%) received it after 42days. There were no significant differences in patient characteristics between these 2 groups. Kaplan-Meier analysis showed that patients with longer time intervals (>42days) had poorer progression-free survival and overall survival (P=0.039 and 0.005, respectively). In the multivariate analysis, patients with longer time intervals had significantly poorer progression-free (hazard ratio, 1.41; 95% confidence interval, 0.98-2.03; not significant) and overall survivals (hazard ratio, 2.03; 95% confidence interval, 1.16-3.54). When the patients were categorized according to time interval quartiles (≤37, 38-42, 43-50, and >50days), longer time intervals were associated with higher risks of recurrence and death (P for trend: 0.006 and <0.001, respectively). CONCLUSION: The time interval from the completion of NAC to the initiation of POAC appears to influence survival. Efforts to reduce the time interval might improve the outcomes in ovarian cancer patients undergoing NAC.
Full Text
https://www.sciencedirect.com/science/article/pii/S0090825817315329
DOI
10.1016/j.ygyno.2017.11.023
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
김상운(Kim, Sang Wun) ORCID logo https://orcid.org/0000-0002-8342-8701
김성훈(Kim, Sung Hoon) ORCID logo https://orcid.org/0000-0002-1645-7473
김영태(Kim, Young Tae) ORCID logo https://orcid.org/0000-0002-7347-1052
남은지(Nam, Eun Ji)
이용재(Lee, Yong Jae) ORCID logo https://orcid.org/0000-0003-0297-3116
이정윤(Lee, Jung-Yun) ORCID logo https://orcid.org/0000-0001-7948-1350
정영신(Chung, Young Shin)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/165397
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