Patients with epithelial ovarian cancer (EOC) are encouraged to have adjuvant chemotherapy administered no later than 42 days after surgery. This research aimed to determine whether or not postponing chemotherapy affected survival for patients with Stage I EOC. Patients with FIGO Stage I EOC who were treated with multi-agent chemotherapy between 2004 and 2015 were identified using the National Cancer Database. After generating Kaplan-Meier curves, researchers compared the OS of patients who received chemotherapy during the first 6 weeks after surgery to those who received chemotherapy between the 6th and 12th week. Investigators built a Cox model to account for potential confounding factors that were predetermined in advance. Adjuvant chemotherapy was administered to 8,549 patients at a median of 35 days (interquartile range 19) after surgery; 67.7% of patients get chemotherapy within 6 weeks of surgery, while 32.3% are delayed. Comorbidities were more common among those who waited longer for care (18.4% vs. 14.9%, P<0.001), and patients who waited longer for care were more likely to be treated in non-academic settings (57.1% vs. 53.1%, P=0.001). When comparing patients with delays to those without, the 5-year OS rates were 85.7% and 89.7%, respectively, P<0.001. The 5-year survival rates for patients with high-grade serous tumors were 81.9% for those with a delay and 88.6% for those without P<0.001. Chemotherapy delays were linked with poorer survival (HR: 1.25, 95% CI: 1.10, 1.42) after accounting for age, race, comorbidities, insurance status, tumor histology and grade, the performance of lymphadenectomy, and substage. Adjuvant chemotherapy is given within 6 weeks of surgery, improving overall survival for patients with early-stage EOC, particularly those with stage IC illness.
Source: sciencedirect.com/science/article/pii/S0090825822003146
