Evaluation of the treatment effectiveness in patients with stage IIB–IIIB ovarian cancer

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Abstract

BACKGROUND: The relevance of the study is due to the urgent problem of assessing therapy effectiveness for stage IIB–IIIB ovarian cancer.

AIM: Study of patients' survival rates after surgical treatment of various forms of stages IIB–IIIB of ovarian cancer depending on a number of clinical and morphological factors.

MATERIAL AND METHODS: The material for the study was long-term observations of patients who received treatment from 2004 to 2021 at the Primorsky Regional Oncology Dispensary, the source was the medical record of an inpatient (form 003/u). The group of patients with stage IIB–IIIB ovarian cancer consisted of 107 patients, average age 50.7±11.5 years. Of these, 43 (40.2%) were women with stage IIB, 46 (43.0%) patients with stage IIIA, 3 (2.8%) patients with stage IIIA2, 15 (14.0%) patients with stage IIIB. Overall survival and progression-free survival were assessed. Statistical methods included survival analysis using the Kaplan–Meier method with the construction of survival curves, medians and standard errors of survival time, and comparison of survival between groups of patients using the log-rank test.

RESULTS: In patients with low-grade serous carcinoma, the five-year progression-free survival rate was higher than in patients with high-grade serous carcinoma (71.1±13.5 and 39.5±7.7%, respectively; p <0.01). Primary surgical treatment performed in gynecological hospitals reduced the median life expectancy and five-year survival rate by 150.0 months and 25.9% (p <0.01; RR=3.4; 95% CI=1.2–9.4). Interval cytoreduction reduced the median time to progression and five-year progression-free survival in patients with stage IIB–IIIB ovarian cancer (53.0±35.2 months and 43.7±16.5%) compared with patients underwent primary surgery (70.0±37.5 months and 57.3±6.0%). The five-year survival rate was higher in patients receiving a combination of platinum and taxanes — 94.7±5.1% (p <0.01; HR=0.2; 95% CI=0.05–0.5).

CONCLUSION: In patients with stage IIB–IIIB ovarian cancer, factors such as primary surgical treatment performed in specialized gynecological oncology hospitals and adjuvant chemotherapy with platinum drugs in combination with taxane agents statistically significantly increase survival.

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About the authors

Varvara N. Zhurman

Primorsky Regional Oncology Center; Pacific State Medical University

Author for correspondence.
Email: varvara2007@yandex.ru
ORCID iD: 0000-0002-6927-3336
SPIN-code: 1781-0007

MD, Cand. Sci. (Med.), Oncologist; Assistant, Depart. of Obstetrics and Gynecology

Russian Federation, Vladivostok; Vladivostok

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2. Fig. 1. Overall survival and progression-free survival of patients with stage IIB–IIIB ovarian cancer (Kaplan–Meier method)

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3. Fig. 2. Overall survival and progression-free survival of patients with stage IIB–IIIB ovarian cancer depending on histological type (Kaplan–Meier method)

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4. Fig. 3. Overall survival and progression-free survival of patients with stage IIB–IIIB ovarian cancer depending on the site of surgery (Kaplan–Meier method); ССОП — specialized gynecological oncology hospital; СГП — gynecological hospital

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5. Fig. 4. Overall survival and progression-free survival of patients with stage IIB–IIIB ovarian cancer depending on the type of surgery (Kaplan–Meier method)

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6. Fig. 5. Overall survival and progression-free survival of patients with stage IIB–IIIB ovarian cancer depending on adjuvant chemotherapy (I-line) (Kaplan–Meier method); РС/ТС + bev — platinum drugs in combination with taxanes and bevacizumab

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