Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine Seoul, Korea.
Division of Gynecologic Oncology, Princess Margaret Cancer Center, Toronto, ON, Canada.
J Gynecol Oncol. 2022 Nov;33(6):e76. doi: 10.3802/jgo.2022.33.e76. Epub 2022 Aug 4.
Our aim was to determine if the time interval between bowel resection and initiation of adjuvant chemotherapy impacts survival in advanced ovarian cancers.
This was a retrospective cohort study using data from two cancer centers, Princess Margaret Cancer Centre in Toronto, Ontario, Canada and Samsung Comprehensive Cancer Center in Seoul, South Korea. Patients with International Federation of Gynecology and Obstetrics (FIGO) stage III or IV ovarian cancer that underwent large bowel resection during primary cytoreductive surgery (PCS) were included.
Ninety-one women were eligible of which the majority (90.1%) were diagnosed with high-grade serous cancer. The median interval from PCS to chemotherapy for all patients was 21 days (7-86 days). Patients were stratified into 3 groups: 1) Interval ≤14 days, 32 (35.2%) patients; 2) Interval between 15-28 days, 27 (29.6%) patients; and 3) Interval between 29-90 days, 32 (35.2%) patients. Surgical procedures and postoperative outcomes were similar between groups. Multivariate analysis indicated that PCS to chemotherapy interval of 2-4 weeks, younger age, and completion of 4 or more adjuvant chemotherapy cycles were independent prognostic factors of favorable overall survival.
Initiation of adjuvant chemotherapy between 2 to 4 weeks after PCS with bowel resection may improve survival outcomes in women with advanced ovarian cancer by maximizing the benefit of PCS plus adjuvant chemotherapy.
本研究旨在确定结直肠切除与辅助化疗起始时间间隔是否影响晚期卵巢癌患者的生存。
这是一项回顾性队列研究，数据来自加拿大安大略省多伦多玛格丽特公主癌症中心和韩国三星综合癌症中心。纳入在初次细胞减灭术（PCS）期间行大肠切除术且国际妇产科联盟（FIGO）分期为 III 期或 IV 期的卵巢癌患者。
共有 91 名女性符合条件，其中大多数（90.1%）被诊断为高级别浆液性癌。所有患者的 PCS 至化疗中位时间间隔为 21 天（7-86 天）。患者分为 3 组：1）间隔≤14 天，32 例（35.2%）；2）间隔 15-28 天，27 例（29.6%）；3）间隔 29-90 天，32 例（35.2%）。各组间手术程序和术后结果相似。多因素分析表明，PCS 至化疗间隔 2-4 周、年龄较小和完成 4 个或更多辅助化疗周期是总生存的独立预后因素。
PCS 加辅助化疗可能会改善晚期卵巢癌患者的生存结局，结直肠切除术后 2-4 周内开始辅助化疗可能通过最大限度地发挥 PCS 加辅助化疗的获益来实现这一目标。
