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      Prognostic significance of tumor necrosis in ovarian cancer patients treated with neoadjuvant chemotherapy and interval surgical debulking.

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          Abstract

          The objective of this study was to study the significance of tumor necrosis documented at the time of interval surgical debulking after neoadjuvant chemotherapy. Retrospective chart reviews were carried out from 1997 to 2005 to identify ovarian cancer patients treated with neoadjuvant chemotherapy. Patients' demographics together with disease characteristics, treatment-related variables, and outcomes were recorded. Cox proportional hazard models were built to model time to progression using predictor variables such as age, cancer stage, tumor grade, residual disease, percentage change in CA125 level from baseline, and degree of necrosis in resected tumor specimens. One hundred one patients were included in the study. Optimal debulking was achieved in 74% of the patients. Cox regressions revealed three significant predictive variables of time to first progression: younger age (hazard ratio [HR] = 0.95, 95% CI 0.92-0.98, P= 0.004), residual disease (P= 0.048), and the absence/minimal tumor necrosis after three cycles of neoadjuvant chemotherapy (HR = 1.97, 95% CI 1.01-3.87, P= 0.048). The estimated median survival was 50.66 months (95% CI 46.12-55.20). The lack of or minimal tumor necrosis after neoadjuvant chemotherapy is an independent risk factor for recurrent disease.

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          Author and article information

          Journal
          Int J Gynecol Cancer
          International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
          Wiley
          1048-891X
          1048-891X
          June 29 2006
          : 16
          : 3
          Affiliations
          [1 ] Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Ottawa, Ottawa General Hospital, 501 Smyth Road, Ottawa, Ontario, Canada. tle@ottawahospital.on.ca
          Article
          IJG594
          10.1111/j.1525-1438.2006.00594.x
          16803473
          13eddc84-aa3a-4050-ac30-f47ec96f26f3
          History

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