Has time to chemotherapy from primary debulking surgery in advanced ovarian cancer an impact on survival? - A population-based nationwide SweGCG study
(2024) In Gynecologic Oncology 186. p.69-76- Abstract
Objective: The aim of the study was to investigate if time to start chemotherapy (TTC) after primary debulking surgery (PDS) impacted relative survival (RS) in advanced epithelial ovarian/fallopian tube/primary peritoneal cancer (EOC). Methods: Nationwide population-based study of women with EOC FIGO stages IIIC-IV, registered 2008–2018 in the Swedish Quality Register for Gynecologic Cancer, treated with PDS and chemotherapy. TTC was categorized into; ≤21 days, 22-28 days, 29-35 days, 36-42 days and > 42 days. Relative survival (RS) was estimated using the Pohar-Perme estimate of net survival. Multivariable analyses of excess mortality rate ratios (EMRRs) were estimated by Poisson regression models. Results: In total, 1694 women were... (More)
Objective: The aim of the study was to investigate if time to start chemotherapy (TTC) after primary debulking surgery (PDS) impacted relative survival (RS) in advanced epithelial ovarian/fallopian tube/primary peritoneal cancer (EOC). Methods: Nationwide population-based study of women with EOC FIGO stages IIIC-IV, registered 2008–2018 in the Swedish Quality Register for Gynecologic Cancer, treated with PDS and chemotherapy. TTC was categorized into; ≤21 days, 22-28 days, 29-35 days, 36-42 days and > 42 days. Relative survival (RS) was estimated using the Pohar-Perme estimate of net survival. Multivariable analyses of excess mortality rate ratios (EMRRs) were estimated by Poisson regression models. Results: In total, 1694 women were included. The median age was 65.0 years. Older age and no residual disease were more common in TTC >42 days than 0–21 days. The RS at 5-years was 37.9% and did not differ between TTC groups. In the R0 (no residual disease) cohort (n = 806), 2-year RS was higher in TTC ≤21 days (91.6%) and 22-28 days (91.4%) than TTC >42 days (79.1%). TTC >42 days (EMRR 2.33, p = 0.026), FIGO stage IV (EMRR 1.83, p = 0.007) and non-serous histology (EMRR 4.20, p < 0.001) were associated with 2-year worse excess mortality compared to TTC 0–21 days, in the R0 cohort. TTC was associated with 2-year survival in the R0 cohort in FIGO stage IV but not in stage IIIC. TTC was not associated with RS in patients with residual disease. Conclusions: For the entire cohort, stage IV, non-serous morphology and residual disease, but not TTC, influenced 5-year relative survival. However, longer TTC was associated with a poorer 2-year survival for those without residual disease after PDS.
(Less)
- author
- Dahm-Kähler, Pernilla ; Rådestad, Angelique Flöter ; Holmberg, Erik ; Borgfeldt, Christer LU ; Bjurberg, Maria LU ; Sköld, Camilla ; Hellman, Kristina ; Kjølhede, Preben ; Stålberg, Karin and Åvall-Lundqvist, Elisabeth
- organization
- publishing date
- 2024-07
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Epithelial ovarian cancer, Primary debulking surgery, Residual disease, Survival, Time to chemotherapy
- in
- Gynecologic Oncology
- volume
- 186
- pages
- 8 pages
- publisher
- Academic Press
- external identifiers
-
- scopus:85189874675
- pmid:38603954
- ISSN
- 0090-8258
- DOI
- 10.1016/j.ygyno.2024.03.011
- language
- English
- LU publication?
- yes
- id
- 5793b27f-7566-41aa-a96b-912b207da43a
- date added to LUP
- 2024-04-23 14:53:02
- date last changed
- 2024-07-16 23:50:20
@article{5793b27f-7566-41aa-a96b-912b207da43a,
abstract = {{<p>Objective: The aim of the study was to investigate if time to start chemotherapy (TTC) after primary debulking surgery (PDS) impacted relative survival (RS) in advanced epithelial ovarian/fallopian tube/primary peritoneal cancer (EOC). Methods: Nationwide population-based study of women with EOC FIGO stages IIIC-IV, registered 2008–2018 in the Swedish Quality Register for Gynecologic Cancer, treated with PDS and chemotherapy. TTC was categorized into; ≤21 days, 22-28 days, 29-35 days, 36-42 days and > 42 days. Relative survival (RS) was estimated using the Pohar-Perme estimate of net survival. Multivariable analyses of excess mortality rate ratios (EMRRs) were estimated by Poisson regression models. Results: In total, 1694 women were included. The median age was 65.0 years. Older age and no residual disease were more common in TTC >42 days than 0–21 days. The RS at 5-years was 37.9% and did not differ between TTC groups. In the R0 (no residual disease) cohort (n = 806), 2-year RS was higher in TTC ≤21 days (91.6%) and 22-28 days (91.4%) than TTC >42 days (79.1%). TTC >42 days (EMRR 2.33, p = 0.026), FIGO stage IV (EMRR 1.83, p = 0.007) and non-serous histology (EMRR 4.20, p < 0.001) were associated with 2-year worse excess mortality compared to TTC 0–21 days, in the R0 cohort. TTC was associated with 2-year survival in the R0 cohort in FIGO stage IV but not in stage IIIC. TTC was not associated with RS in patients with residual disease. Conclusions: For the entire cohort, stage IV, non-serous morphology and residual disease, but not TTC, influenced 5-year relative survival. However, longer TTC was associated with a poorer 2-year survival for those without residual disease after PDS.</p>}},
author = {{Dahm-Kähler, Pernilla and Rådestad, Angelique Flöter and Holmberg, Erik and Borgfeldt, Christer and Bjurberg, Maria and Sköld, Camilla and Hellman, Kristina and Kjølhede, Preben and Stålberg, Karin and Åvall-Lundqvist, Elisabeth}},
issn = {{0090-8258}},
keywords = {{Epithelial ovarian cancer; Primary debulking surgery; Residual disease; Survival; Time to chemotherapy}},
language = {{eng}},
pages = {{69--76}},
publisher = {{Academic Press}},
series = {{Gynecologic Oncology}},
title = {{Has time to chemotherapy from primary debulking surgery in advanced ovarian cancer an impact on survival? - A population-based nationwide SweGCG study}},
url = {{http://dx.doi.org/10.1016/j.ygyno.2024.03.011}},
doi = {{10.1016/j.ygyno.2024.03.011}},
volume = {{186}},
year = {{2024}},
}