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Postoperative chemotherapy had no prognostic effect on early-staged young ovarian cancer with unilateral resection.

ABSTRACT: Postoperative chemotherapy has been widely used in the treatment of early-staged ovarian cancer patients underwent unilateral resection, but the clinical decision mainly depends on the doctor's experience without a well-defined guideline. This study used propensity score matching to analyze the effect of postoperative chemotherapy for early-staged ovarian cancer patients underwent unilateral resection on prognosis. Patients of age 50 or younger than 50 with early-staged ovarian cancer were explored from the Surveillance, Epidemiology, and End Results program database during 2000-2018. Propensity score matching was used to randomize the dataset and reduce the selection biases. Univariate and multivariate cox proportional hazards models were utilized to estimate the necessity of chemotherapy. In univariate analysis of matched population, both the overall survival and cancer-specific survival analysis showed that chemotherapy had no effect on the prognosis of early-staged young ovarian cancer patients (Overall survival, P = 0.477; Cancer-specific survival, P = 0.950). In propensity-adjusted multivariate analysis, chemotherapy still had no effect on both the overall and cancer-specific survival probability after excluding the effect of all the confounding factors (HR = 0.863, CI = 0.587-1.269, P = 0.455; HR = 1.009, CI = 0.633-1.607, P = 0.970). Our study suggested that postoperative chemotherapy is not necessary for early-staged young ovarian cancer patients with unilateral resection, as indicated by both the overall survival and cancer-specific survival.

SUBMITTER: Zhang X

PROVIDER: S-EPMC6246923 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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Postoperative chemotherapy had no prognostic effect on early-staged young ovarian cancer with unilateral resection.

Zhang Xiaofei X Wang Shuoer S Zhao SongJiao S Sun Yidi Y Yang Gong G

Cancer medicine 20181010 11

Postoperative chemotherapy has been widely used in the treatment of early-staged ovarian cancer patients underwent unilateral resection, but the clinical decision mainly depends on the doctor's experience without a well-defined guideline. This study used propensity score matching to analyze the effect of postoperative chemotherapy for early-staged ovarian cancer patients underwent unilateral resection on prognosis. Patients of age 50 or younger than 50 with early-staged ovarian cancer were explo ...[more]

PMID: 30306725

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Project description:ObjectiveTo examine the association between postoperative chemotherapy and survival of women with stage IC mucinous ovarian cancer (MOC).MethodsComprehensive nationwide tumor registry data from the Commission on Cancer-accredited facilities in the United States from 2004 to 2014 were retrospectively examined. Women with stage IC MOC who underwent primary surgery followed by postoperative chemotherapy were compared to those who did not receive. Clinico-pathological factors associated with chemotherapy use, and overall survival associated with chemotherapy use were examined with multivariable models and propensity score inverse probability of treatment weighting (IPTW). External validation was performed by examining the Surveillance, Epidemiology, and End Results Program from 1988 to 2014.ResultsThere were 532 (58.5%) women who received postoperative chemotherapy and 377 (41.5%) women who did not. On multivariable analysis, those with moderately-/poorly-differentiated tumors, large tumor size, and who underwent lymphadenectomy were more likely to receive postoperative chemotherapy whereas young women and those with capsule rupture alone were less likely to receive postoperative chemotherapy (all, P < 0.05). After IPTW, there was no difference in overall survival among women who received postoperative chemotherapy versus those who did not on multivariable analysis (adjusted 4-year rates: 85.8% versus 86.3%, adjusted-hazard ratio [HR] 0.88, 95% confidence interval [CI] 0.60-1.31). Similarly, there was no benefit with chemotherapy regardless of patient age, tumor differentiation, performance of nodal dissection, and substage groups. Among 912 cases in the validation cohort (postoperative chemotherapy use, n = 520 [57.0%]), postoperative chemotherapy use was not associated with cause-specific survival (adjusted-HR 1.296, 95% CI 0.846-1.984, P = 0.233) or overall survival (adjusted-HR 1.131, 95% CI 0.849-1.508, P = 0.400).ConclusionPostoperative chemotherapy was received by fewer than 60% of women with stage IC MOC, and postoperative chemotherapy was not associated with improved survival.

Project description:BackgroundCirculating angiogenic cytokines (CACs) have been confirmed as prognostic biomarkers and therapeutic targets in several solid tumors. However, their role as prognostic biomarkers in resected pancreatic ductal adenocarcinoma (PDAC) is unknown.ResultsThe expression of CACs in patients with PDAC differs from those with CP both pre- and postoperatively. Correlation analyses show significant correlations between circulating levels of CACs: VEGF was correlated with IL-6 (r = 0.457), FGF (r = 0.44), G-CSF (r = 0.543), HGF (r = 0.586) and SDF-1α (r = 0.784) before the surgery. The circulating levels of TNF-α correlated with the serum concentration of IL-4 before (r= 0.656) and after the resection (r = 0.776 on POD 3, r = 0.865 on POD 7). Gender did not show any correlation with serum levels of CAC, except for significantly higher levels of EGF in males (P = 0.002). Other clinicopathological variables such as age (< 65 vs. > 65 years), T, N, or UICC stage did not have an association with the cytokine levels. The multivariate model including the entire angiogenic panel revealed that postoperative increasing levels of EGF (P = 0.023), PDGFA-A (P = 0.024), TNF-α (P = 0.001) and IL-8 (P = 0.049) were associated with a favorable prognosis, whereas elevating levels of VEGF (P = 0.005) correlated with a poor cancer-specific survival.Materials and methodsPreoperative and postoperative blood samples were collected in patients undergoing surgery for PDAC (n = 40) or chronic pancreatitis (CP; n = 9). Serum levels of 13 angiogenic cytokines (IL-4, IL-6, FGF-b, G-CSF, TNF-α, VEGF, HGF, SDF-1α, IL-8, EGF, Ang-1, PDGF-AA and PlGF) were analyzed using ELISA and Multiplex. Prognostic factors were identified by a Cox proportional hazards model.ConclusionsPostoperative changes of serum levels of certain angiogenic cytokines correlate with patients' prognosis after resection for pancreatic cancer. CACs should thus be considered as biomarkers in patients with resected pancreatic cancer.

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Postoperative chemotherapy had no prognostic effect on early-staged young ovarian cancer with unilateral resection.

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Postoperative chemotherapy had no prognostic effect on early-staged young ovarian cancer with unilateral resection.

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