التفاصيل البيبلوغرافية
| العنوان: |
Delay in adjuvant chemotherapy administration for patients with FIGO stage I epithelial ovarian carcinoma is associated with worse survival; an analysis of the National Cancer Database. |
| المؤلفون: |
Nasioudis, Dimitrios1 (AUTHOR) dimitrios.nasioudis@uphs.upenn.edu, Mastroyannis, Spyridon A.1 (AUTHOR), Ko, Emily M.1 (AUTHOR), Haggerty, Ashley F.1 (AUTHOR), Cory, Lori1 (AUTHOR), Giuntoli II, Robert L.1 (AUTHOR), Kim, Sarah H.1 (AUTHOR), Morgan, Mark A.1 (AUTHOR), Latif, Nawar A.1 (AUTHOR) |
| المصدر: |
Gynecologic Oncology. Aug2022, Vol. 166 Issue 2, p263-268. 6p. |
| مصطلحات موضوعية: |
*LYMPHADENECTOMY, *ADJUVANT chemotherapy, *TREATMENT delay (Medicine), *OVARIAN epithelial cancer, *LOG-rank test, *OVERALL survival, *TUMOR grading |
| مستخلص: |
The administration of adjuvant chemotherapy within 42 days from surgery is one of the proposed quality measures for patients with epithelial ovarian cancer (EOC). The aim of the present study was to evaluate the impact of chemotherapy delay in the survival of patients with stage I EOC. The National Cancer Database was accessed, and patients diagnosed between 2004 and 2015 with FIGO stage I EOC who received multi-agent chemotherapy were identified. Overall survival (OS) was compared between patients who received chemotherapy <6 weeks and 6–12 weeks from surgery with the log-rank test following generation of Kaplan-Meier curves. Cox model was constructed to control for a priori selected confounders. A total of 8549 patients who received adjuvant chemotherapy at a median 35 days from surgery (interquartile range 19) were identified; 67.7% received adjuvant chemotherapy <6 weeks from surgery while 32.3% experienced a delay. Patients who experienced a delay were more likely to have comorbidities (18.4% vs 14.9%, p < 0.001), and be managed in non-academic facilities (57.1% vs 53.2%, p = 0.001). Patients who experienced a delay had worse OS compared to those who did not, p < 0.001; 5-year OS rates 85.7% and 89.7%, respectively. For patients with high-grade serous tumors, those who experienced a delay had a 5-yr OS of 81.9% compared to 88.6% for those who did not, p < 0.001. After controlling for age, race, presence of comorbidities, insurance status, tumor histology and grade, performance of lymphadenectomy and substage, chemotherapy delay was associated with worse survival (HR: 1.25, 95% CI: 1.10, 1.42). For patients with early stage EOC administration of adjuvant chemotherapy within 6 weeks from surgery was associated with better overall survival, especially for those with stage IC disease. • 1 in 3 patients with stage I EOC experience a delay in adjuvant chemotherapy administration following staging surgery. • Delay in adjuvant chemotherapy has a negative impact on overall survival. • Detrimental impact is more pronounced for patients with stage IC or high-grade serous histology. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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