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Journal article
Does aggressive surgery improve outcomes? Interaction between preoperative disease burden and complex surgery in patients with advanced-stage ovarian cancer: an analysis of GOG 182
Journal of clinical oncology, v 33(8), pp 937-943
10 Mar 2015
PMID: 25667285
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To examine the effects of disease burden, complex surgery, and residual disease (RD) status on progression-free (PFS) and overall survival (OS) in patients with advanced epithelial ovarian cancer (EOC) or primary peritoneal cancer (PPC) and complete surgical resection (R0) or < 1 cm of RD (MR) after surgical cytoreduction.
Demographic, pathologic, surgical, and outcome data were collected from 2,655 patients with EOC or PPC enrolled onto the Gynecologic Oncology Group 182 study. The effects of disease distribution (disease score [DS]) and complexity of surgery (complexity score [CS]) on PFS and OS were assessed using the Kaplan-Meier method and multivariable regression analysis.
Consistent with existing literature, patients with MR had worse prognosis than R0 patients (PFS, 15 v 29 months; P < .01; OS, 41 v 77 months; P < .01). Patients with the highest preoperative disease burden (DS high) had shorter PFS (15 v 23 or 34 months; P < .01) and OS (40 v 71 or 86 months; P < .01) compared with those with DS moderate or low, respectively. This relationship was maintained in the subset of R0 patients with PFS (18.3 v 33.2 months; DS moderate or low: P < .001) and OS (50.1 v 82.8 months; DS moderate or low: P < .001). After controlling for DS, RD, an interaction term for DS/CS, performance status, age, and cell type, CS was not an independent predictor of either PFS or OS.
In this large multi-institutional sample, initial disease burden remained a significant prognostic indicator despite R0. Complex surgery does not seem to affect survival when accounting for other confounding influences, particularly RD.
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Details
- Title
- Does aggressive surgery improve outcomes? Interaction between preoperative disease burden and complex surgery in patients with advanced-stage ovarian cancer: an analysis of GOG 182
- Creators
- Neil S Horowitz - Brigham and Women's HospitalAustin Miller - Brigham and Women's HospitalBunja Rungruang - Brigham and Women's HospitalScott D Richard - Brigham and Women's HospitalNoah Rodriguez - Brigham and Women's HospitalMichael A Bookman - Brigham and Women's HospitalChad A Hamilton - Brigham and Women's HospitalThomas C Krivak - Brigham and Women's HospitalG Larry Maxwell - Brigham and Women's Hospital
- Publication Details
- Journal of clinical oncology, v 33(8), pp 937-943
- Grant note
- U10 CA180868 / NCI NIH HHS U10 CA180822 / NCI NIH HHS U10 CA180867 / NCI NIH HHS UG1 CA189867 / NCI NIH HHS U10 CA027469 / NCI NIH HHS CA 27469 / NCI NIH HHS U10 CA037517 / NCI NIH HHS CA 37517 / NCI NIH HHS UG1 CA233180 / NCI NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Obstetrics and Gynecology
- Web of Science ID
- WOS:000356055600022
- Scopus ID
- 2-s2.0-84924940396
- Other Identifier
- 991019167879004721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Oncology