9/28/2023 0 Comments Prognostic factorOur study included OC patients who met all of the following criteria: (1) whose histologic subtype was high-grade (grade 2 or 3) serous ovarian cancer (2) who was staged at an advanced disease (FIGO stage IIB to IVA) (3) who received a debulking surgery (through an open laparotomy) performed by experienced gynecologic oncologists with qualification for OC surgery (4) who achieved optimal cytoreduction after debulking surgery (5) who received postoperative chemotherapy with recommended regimens, such as paclitaxel (135–175 mg/m 2, intravenously) followed by carboplatin (300–400 mg/m 2, intravenously) or paclitaxel (135–175 mg/m 2, intravenously) followed by cisplatin (75–100 mg/m 2, intraperitoneally) for 6–8 cycles (6) who achieved CR after primary treatment (optimal cytoreduction with fist-line postoperative chemotherapy) and (7) who had complete clinical data during follow-up after the primary treatment. Signed informed consent forms were obtained from all patients whose clinical data were collected. We reviewed the clinical characteristics and outcomes of patients diagnosed with advanced-stage HGSOC who were treated in West China Second Hospital, Sichuan University, People’s Republic of China, from January 2013 to December 2017. In order to identify more valuable prognostic factors for disease recurrence, we conducted this nested case-control study to evaluate further characteristics of relapsed HGSOC patients with advanced disease who had achieved complete clinical remission (CR) after primary treatment. Woman with high-grade serous ovarian cancer (HGSOC), which is the most aggressive histologic subtype and accounts for the majority of advanced-stage diseases, is more likely to have a bad prognosis. However, relapses are still common in patients even with no evidence of disease after primary treatment. Achieving optimal cytoreduction (with residual disease less than 1 cm in maximum diameter or thickness after debulking surgery) is one of the most important components to improve outcomes in advanced-stage patients. Currently, the well-known factors with prognostic value for disease recurrence in OC patients included International Federation of Gynecology and Obstetrics (FIGO) staging, pathological type, outcome of debulking surgery, and platinum sensitivity. Unfortunately, over two-thirds of advanced-stage OC patients might relapse within the subsequent 3 years after primary treatment. The standard-of-care treatment for a newly diagnosed OC patient is debulking surgery combined with perioperative platinum-based chemotherapy. Due to the lack of specific symptoms at early stage, more than 70% of OC patients are diagnosed at advanced stage with a low 5-year overall survival rate. Epithelial ovarian cancer (OC) comprises about 90% of malignant ovarian neoplasms. Ovarian cancer remains one of the Top 10 most common cancers for global women in global cancer statistics 2020, and is the leading cause of death among all gynecologic malignancy. ConclusionĪ low serum CA-125 level after primary treatment was a potential prognostic factor in women with advanced HGSOC. Furthermore, as shown in line graphs recording serum CA-125 levels during follow-up in each recurrent case, the increments of serum CA-125 levels were delayed in recurrent OC patients who had a posttreatment CA125 level ≤ 10 U/ml compared with those with a higher CA-125 level. Patients with a higher posttreatment CA-125 level showed an increased risk for OC relapse compared to those with a lower posttreatment CA-125 level. The median time (from initiation of treatment) until relapse was 25 months for patients whose posttreatment CA-125 levels were higher than 10 U/ml, while it was undefined for patients whose posttreatment CA-125 level were ≤ 10 U/ml. In Cox regression, the posttreatment CA-125 level was identified as a prognostic factor for recurrence with an OR of 1.05 (95% CI: 1.02–1.10, P = 0.033). A cutoff value was set at the median level in the recurrent group (10 U/ml) to categorize patients into two arms. Among all the variables, the difference in posttreatment CA-125 level was statistically significant ( P <0.05) between the recurrent group and the progression-free group in both univariate and multivariable analysis. Fifty-seven patients (58.8%) relapsed within 3 years after CR. Ninety-seven patients were finally included. Cox regression was used to calculate the time to event analysis in different groups. The primary outcome was recurrence of disease within 3 years after clinical remission (CR). MethodsĪ nested case-control study was conducted in a large medical center in Southwest China. We aimed to identify the prognostic factors for disease recurrence in these patients. ![]() ![]() Relapses are common in patients even with no evidence of disease after primary treatment. Women with advanced-stage high-grade serous ovarian cancer (HGSOC) are likely to have a bad prognosis.
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