Ovarian Cancer Canada

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Survival Impact of Complete Cytoreduction to No Gross Residual Disease for Advanced-Stage Ovarian Cancer: A Meta-Analysis

Highlights

  • The proportion of patients left with no gross residual disease is independently predictive of survival.
  • The proportion of patients receiving intraperitoneal chemotherapy is a significant predictor of cohort survival time.
  • These data underscore the synergy between regional therapeutic efficacy and the completeness of surgical resection. 

Suk-Joon Chang, Melissa Hodeib, Jenny Chang, Robert E. Bristow

http://www.sciencedirect.com/science/article/pii/S0090825813008299

Abstract 

Objective To quantify the impact of complete cytoreduction to no gross residual disease on overall survival among patients with advanced-stage ovarian cancer treated during the platinum-taxane era.

Methods PubMed and Cochrane Library databases were searched for all articles on primary cytoreductive surgery for advanced-stage ovarian cancer published from 1/1996-7/2011. A total of 18 relevant studies (13,257 patients) were identified for analysis. Simple and multiple linear regression analyses, with weighted correlation calculations, were used to assess the effect on median survival time of clinical and treatment-related factors.

Results The mean weighted median overall survival time for all cohorts was 44.4 months (range, 27.6–66.9 months). Simple linear regression analysis revealed that residual disease, stage IV disease, and use of intraperitoneal chemotherapy were significantly associated with median survival time. After controlling for other factors on multiple linear regression analysis, each 10% increase in the proportion of patients undergoing complete cytoreduction to no gross residual disease was associated with a significant and independent 2.3-month increase (95%CI = 0.6-4.0, p = 0.011) in cohort median survival compared to a 1.8-month increase (95%CI = 0.6-3.0, p = 0.004) in cohort median survival for optimal cytoreduction (residual disease ≤ 1 cm). Each10% increase in the proportion of patients receiving intraperitoneal chemotherapy was associated with a significant and independent 3.9-month increase (95%CI = 1.1-6.8 p = 0.008) in median cohort survival time.

Conclusions For advanced-stage ovarian cancer treated during the platinum-taxane era, the proportion of patients left with no gross residual disease and receiving intraperitoneal chemotherapy are independently significant factors associated with the most favorable cohort survival time.

Information

This entry was posted on June 21, 2013 by in Research Updates and tagged , , , .

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