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Outcomes of Non-High Grade Serous Carcinoma after Neoadjuvant Chemotherapy for Advanced-Stage Ovarian Cancer: Single-Institution Experience

 Young Shin Chung  ;  Jung-Yun Lee  ;  Hyun-Soo Kim  ;  Eun Ji Nam  ;  Sang Wun Kim  ;  Young Tae Kim 
 YONSEI MEDICAL JOURNAL, Vol.59(8) : 930-936, 2018 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Cystadenocarcinoma, Serous/mortality ; Cystadenocarcinoma, Serous/pathology ; Cystadenocarcinoma, Serous/therapy* ; Cytoreduction Surgical Procedures ; Disease-Free Survival ; Female ; Humans ; Middle Aged ; Neoadjuvant Therapy/methods* ; Neoplasm Staging ; Ovarian Neoplasms/mortality ; Ovarian Neoplasms/pathology ; Ovarian Neoplasms/therapy* ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate ; Treatment Outcome
Ovarian neoplasm ; adenocarcinoma, clear cell ; adenocarcinoma, mucinous ; neoadjuvant therapy ; survival rate
PURPOSE: Outcomes in patients with ovarian high-grade serous carcinoma (HGSC) treated with neoadjuvant chemotherapy (NAC) have been widely studied; however, there is limited information on responses to chemotherapy among patients with non-HGSC. The aim of this study was to compare the survival outcomes of patients with advanced-stage non-HGSC and HGSC treated with NAC. MATERIALS AND METHODS: This study was a retrospective analysis of patients with advanced-stage ovarian cancer treated at Yonsei Cancer Hospital between 2006 and 2017. The demographics, chemotherapy response, and survival rates were compared between patients with non-HGSC and those with HGSC. RESULTS: Among 220 patients who underwent NAC, 25 (11.4%) patients had non-HGSC histologic subtypes, and all received a taxane-platinum combination regimen for NAC. Patients with non-HGSC had lower baseline cancer antigen-125 levels (p<0.001), poorer response rates (p<0.001), lower rates of optimal cytoreduction (p=0.003), and poorer progression-free survival (PFS) (median PFS 10.3 months vs. 18.3 months; p=0.009) and overall survival (OS) (median OS 25.5 months vs. 60.6 months; p<0.001), compared to those with HGSC. In multivariate analysis, non-HGSC was a negative prognostic factor for both PFS [hazard ratio (HR), 3.19; 95% confidence interval (CI), 1.73-5.88] and OS (HR, 4.22; 95% CI, 2.07-8.58). CONCLUSION: In this study, poorer survival outcomes were observed in patients who underwent NAC for treatment of non-HGSC versus those treated for HGSC. Different treatment strategies are urgently required to improve survival outcomes for patients with non-HGSC undergoing NAC.
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1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sang Wun(김상운) ORCID logo https://orcid.org/0000-0002-8342-8701
Kim, Young Tae(김영태) ORCID logo https://orcid.org/0000-0002-7347-1052
Kim, Hyun-Soo(김현수)
Nam, Eun Ji(남은지) ORCID logo https://orcid.org/0000-0003-0189-3560
Lee, Jung-Yun(이정윤) ORCID logo https://orcid.org/0000-0001-7948-1350
Chung, Young Shin(정영신)
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