One of the proposed quality metrics for patients with epithelial ovarian cancer (EOC) is the provision of adjuvant chemotherapy within 42 days of surgery. The purpose of this research was to determine how postponing treatment affected the survival of individuals with stage I EOC. Patients diagnosed with FIGO stage I EOC between 2004 and 2015 and treated with multi-agent chemotherapy were retrieved from the National Cancer Database. After generating Kaplan-Meier curves, researchers compared the overall survival (OS) of patients who received chemotherapy during the first 6 weeks after surgery to those who received chemotherapy between the sixth and twelfth weeks after surgery using the log-rank test. For this reason, a Cox model was developed to account for predetermined confounders. Out of 8,549 patients, investigators found that 67.7% received adjuvant chemotherapy within 6 weeks of surgery, while 32.3% had a delay. Comorbidities were more common among patients 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). In a P less than 0.001 comparisons, patients who had a delay had a shorter overall survival time than those who did not; the 5-year OS rates for the 2 groups were 85.7% and 89.7%, respectively. High-grade serous tumor patients who encountered a delay had a 5-yr OS of 81.9%, compared to 88.6% for those who did not, with P less than 0.001. Delaying chemotherapy was linked with poorer survival (HR: 1.25, 95% CI: 1.10, 1.42), even after adjusting for age, race, presence of comorbidities, insurance status, tumor histology and grade, the performance of lymphadenectomy, and substage. Adjuvant chemotherapy given to patients with early-stage EOC within 6 weeks of surgery was related to higher overall survival, especially for those with stage IC illness.
Source: sciencedirect.com/science/article/pii/S0090825822003146
