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Treatment Outcomes of Epithelial Ovarian Cancers Following Maximum Cytoreduction and Adjuvant Paclitaxel-Carboplatin Chemotherapy: Egyptian NCI Experience

  • Nassar, Hanan Ramadan (Medical Oncology Department, NCI, Cairo University) ;
  • Zeeneldin, Ahmed A (Medical Oncology Department, NCI, Cairo University) ;
  • Helal, Amany Mohamed (Medical Oncology Department, NCI, Cairo University) ;
  • Ismail, Yahia Mahmoud (Medical Oncology Department, NCI, Cairo University) ;
  • Elsayed, Abeer Mohamed (Pathology Department, NCI, Cairo University) ;
  • Elbassuiony, Mohamed A (Medical Oncology Department, NCI, Cairo University) ;
  • Moneer, Manar M (Statistical Department, NCI, Cairo University)
  • Published : 2015.11.04

Abstract

Background: Epithelial ovarian cancer (EOC) is the commonest malignancy involving the ovaries. Maximum surgical cytoreduction (MCR) followed by adjuvant taxane-platinum chemotherapy are the standard of care treatments. Aims: To study treatment outcomes of EOC patients that were maximally cyto-reduced and received adjuvant paclitaxel-carboplatin (PC) chemotherapy. Materials and Methods: This retrospective cohort study included 174 patients with EOC treated at the Egyptian National Cancer Institute between 2006 and 2010. For inclusion, they should have had undergone MCR with no-gross residual followed by adjuvant PC chemotherapy. MCR was total abdominal hysterectomy/bilateral salpingo-oophorectomy [TAH/BSO] or unilateral salpingo-oophorectomy [USO] plus comprehensive staging. Results: The median age was 50 years. Most patients were married (97.1%), had offspring (92.5%), were postmenopausal (53.4%), presented with abdominal/pelvic pain and swelling (93.7%), had tumors involving both ovaries (45.4%) without extra-ovarian extension i.e. stage I (55.2%) of serous histology (79.9%) and grade II (87.4%). TAH/BSO was performed in 97.7% of cases. A total of 1,014 PC chemotherapy cycles were administered and were generally tolerable with 93.7% completing 6 cycles. Alopecia and numbness were the commonest adverse events. The median follow up period was 42 months. The 2-year rates for disease free survival (DFS) and overall survival (OS) were 70.7% and 94.8%, respectively. The respective 5-year rates were 52.6% and 81.3%. Advanced stage and high-grade were significantly associated with poor DFS and OS (p<0.001). Age >65 years was associated with poor OS (p =0.008). Using Cox-regression, stage was independent predictor of poor DFS and OS. Age was an independent predictor of poor OS.

Keywords

Ovarian neoplasms;epithelial;Egypt, National Cancer Institute;cytoreduction;adjuvant chemotherapy

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