Yonsei Med J.  2018 Oct;59(8):930-936. 10.3349/ymj.2018.59.8.930.

Outcomes of Non-High Grade Serous Carcinoma after Neoadjuvant Chemotherapy for Advanced-Stage Ovarian Cancer: Single-Institution Experience

• Chung YS
• Lee JY
• Kim HS
• Nam EJ
• Kim SW
• Kim YT

• KMID: 2419726
• DOI: http://doi.org/10.3349/ymj.2018.59.8.930

Abstract

PURPOSE
Outcomes in patients with ovarian high-grade serous carcinoma (HGSC) treated with neoadjuvant chemotherapy (NAC) have been widely studied; however, there is limited information on responses to chemotherapy among patients with non-HGSC. The aim of this study was to compare the survival outcomes of patients with advanced-stage non-HGSC and HGSC treated with NAC.
MATERIALS AND METHODS
This study was a retrospective analysis of patients with advanced-stage ovarian cancer treated at Yonsei Cancer Hospital between 2006 and 2017. The demographics, chemotherapy response, and survival rates were compared between patients with non-HGSC and those with HGSC.
RESULTS
Among 220 patients who underwent NAC, 25 (11.4%) patients had non-HGSC histologic subtypes, and all received a taxane-platinum combination regimen for NAC. Patients with non-HGSC had lower baseline cancer antigen-125 levels (p < 0.001), poorer response rates (p < 0.001), lower rates of optimal cytoreduction (p=0.003), and poorer progression-free survival (PFS) (median PFS 10.3 months vs. 18.3 months; p=0.009) and overall survival (OS) (median OS 25.5 months vs. 60.6 months; p < 0.001), compared to those with HGSC. In multivariate analysis, non-HGSC was a negative prognostic factor for both PFS [hazard ratio (HR), 3.19; 95% confidence interval (CI), 1.73-5.88] and OS (HR, 4.22; 95% CI, 2.07-8.58).
CONCLUSION
In this study, poorer survival outcomes were observed in patients who underwent NAC for treatment of non-HGSC versus those treated for HGSC. Different treatment strategies are urgently required to improve survival outcomes for patients with non-HGSC undergoing NAC.

Keyword

Ovarian neoplasm; neoadjuvant therapy; survival rate; adenocarcinoma, clear cell; adenocarcinoma, mucinous

MeSH Terms

Adenocarcinoma, Clear Cell
Adenocarcinoma, Mucinous
Cancer Care Facilities
Demography
Disease-Free Survival
Drug Therapy*
Humans
Multivariate Analysis
Neoadjuvant Therapy
Ovarian Neoplasms*
Retrospective Studies
Survival Rate

Figure

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  Fig. 1 Flow diagram of the study population. FIGO, International Federation of Gynecology and Obstetrics; HGSC, high-grade serous carcinoma; LGSC, low-grade serous carcinoma.

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  Fig. 2 Kaplan-Meier survival curves of (A) PFS and (B) OS according to histological subtype. HGSC, high-grade serous carcinoma; PFS, progression-free survival; OS, overall survival.

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