Abstract
Background
Previous studies on adjuvant chemotherapy for patients with ovarian clear cell carcinoma (OCCC) have included a limited number of Asian patients with surgical stage I OCCC, despite differences in OCCC survival by race and stage. The aim of this study was to estimate the survival effect of the number of cycles of adjuvant taxane plus carboplatin chemotherapy in Asian patients with surgical stage I OCCC.
Methods
We retrospectively identified 227 patients with surgical stage I OCCC at 14 institutions from 1995 to 2017. Kaplan–Meier analysis and Cox proportional hazard regression with inverse probability of treatment weighting (IPTW) adjustment were performed to evaluate overall survival (OS) and recurrence-free survival (RFS) in patients receiving ≤ 3 and 4–6 cycles of taxane plus platinum adjuvant chemotherapy.
Results
Eighty-nine and 138 patients received ≤ 3 and 4–6 cycles of adjuvant chemotherapy, respectively. There was no between-group difference in OS or RFS with or without IPTW adjustment. In Cox proportional hazards analysis, 4–6 cycles of adjuvant chemotherapy were not associated with improved OS (HR 1.090; 95% CI 0.518–2.291; p = 0.821) or RFS (HR 1.144; 95% CI 0.619–2.114; p = 0.669) compared to ≤ 3 cycles, even with IPTW adjustment. Subgroup analysis in different substages of stage I OCCC showed that the number of cycles of adjuvant chemotherapy had no impact on OS or RFS.
Conclusion
Three or fewer cycles of taxane plus carboplatin chemotherapy may be a reasonable treatment regime for patients with surgical staging I OCCC.
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The authors sincerely thank TOTSG members for collaborating in the data collection.
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10147_2021_2075_MOESM1_ESM.pptx
Supplementary Fig. 1 Survival difference in Kaplan–Meier-estimated OS (a) and RFS (b) curves in stage IA OCCC patients who received 0, 1–3, or 4–6 cycles of adjuvant chemotherapy. p-values were estimated using the log-rank test. OCCC, ovarian clear cell carcinoma; OS, overall survival; RFS, recurrence-free survival; CI, confidence interval. Supplementary Fig. 2 Survival differences in stage IC OCCC. Kaplan–Meier-estimated OS and RFS curves in stage IC (a, b) OCCC patients who received 0, 1–3, or 4–6 cycles of adjuvant chemotherapy and stage IC2/IC3 (c, d) OCCC patients who received, ≤ 3 or 4–6 cycles of adjuvant chemotherapy. p-values were estimated using the log-rank test. OCCC, ovarian clear cell carcinoma; OS, overall survival; RFS, recurrence-free survival; CI, confidence interval. (PPTX 160 kb)
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Ukai, M., Suzuki, S., Yoshihara, M. et al. Adjuvant taxane plus platinum chemotherapy for stage I ovarian clear cell carcinoma with complete surgical staging: are more than three cycles necessary?. Int J Clin Oncol 27, 609–618 (2022). https://doi.org/10.1007/s10147-021-02075-8
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DOI: https://doi.org/10.1007/s10147-021-02075-8