ISSN:
1569-8041
Keywords:
adjuvant chemotherapy
;
DNA ploidy
;
early ovarian cancer
;
intergroup prospective trials
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Purpose:Adjuvant chemotherapy versus observation and chemotherapyat progression was evaluated in 162 patients in a prospective randomizedmulticenter study. We also evaluated DNA-measurements as an additionalprognostic factor. Patients and methods:Patients received adjuvant carboplatin AUC7 every 28 days for six courses (n = 81) or no adjuvant treatment(n = 81). Eligibility included surgically staged and treated patientswith FIGO stage I disease, grade 1 aneuploid or grade 2 or 3 non-clear cellcarcinomas or clear cell carcinomas. Disease-free (DFS) and disease-specific(DSS) survival were end-points. Results:Median follow-up time was 46 months and progression wasobserved in 20 patients in the treatment group and 19 in the control group.Estimated five-year DFS and DSS were 70% and 86% in thetreatment group and 71% and 85% in the control group. The hazardratio was 0.98 (95% confidence interval (95% CI):0.52–1.83) regarding DFS and 0.94 (95% CI: 0.37–2.36)regarding DSS. No significant differences in DFS or DSS could be seen when thelog-rank test was stratified for prognostic variables. Therefore, data fromboth groups were pooled for the analysis of prognostic factors. DNA-ploidy(P = 0.003), extracapsular growth (P = 0.005), tumor rupture(P = 0.04), and WHO histologic grade (P = 0.04) weresignificant independent prognostic factors for DFS withP 〈 0.0001for the model in the multivariate Cox analysis. FIGO substage (P =0.01), DNA ploidy (P 〈 0.05), and histologic grade (P =0.05) were prognostic for DSS with a P-value for the model 〈0.0001. Conclusions:Due to the small number of patients the study wasinconclusive as regards the question of adjuvant chemotherapy. The survivalcurves were superimposable, but with wide confidence intervals. DNA-ploidyadds objective independent prognostic information regarding both DFS and DSSin early ovarian cancer.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1023/A:1008399414923
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