+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Variability in chemotherapy delivery for elderly women with advanced stage ovarian cancer and its impact on survival



Variability in chemotherapy delivery for elderly women with advanced stage ovarian cancer and its impact on survival



British Journal of Cancer 98(7): 1197-1203



Given the survival benefits of adjuvant chemotherapy for advanced ovarian cancer (OC), we examined the associations of survival with the time interval from debulking surgery to initiation of chemotherapy and with the duration of chemotherapy. Among patients >= 65 years with stages III/IV OC diagnosed between 1991 and 2002 in the Surveillance, Epidemiology, and End Results-Medicare database, we developed regression models of predictors of the time interval from surgery to initiation of chemotherapy and of the total duration of chemotherapy. Survival was examined with Cox proportional hazards models. Among 2558 patients, 1712 (67%) initiated chemotherapy within 6 weeks of debulking surgery, while 846 (33%)began treatment >6 weeks. Older age, black race, being unmarried, and increased comorbidities were associated with delayed initiation of chemotherapy. Delay of chemotherapy was associated with an increase in mortality (hazard ratio (HR) 1.11; 95% CI, 1.0-1.2). Among 1932 patients in the duration of treatment analysis, the 1218 (63%) treated for 3-7 months had better survival than the 714 (37%) treated for <= 3 months (HR = 0.84; 95% CI, 0.75-0.94). This analysis represents one of the few studies describing treatment delivery and outcome in women with advanced OC. Delayed initiation and early discontinuation of chemotherapy were common and associated with increased mortality.

Accession: 034181287

Download citation: RISBibTeXText

PMID: 18349836

DOI: 10.1038/sj.bjc.6604298


Related references

Neoadjuvant chemotherapy (NACT) is an effective way of managing elderly women with advanced stage ovarian cancer (FIGO Stage IIIC and IV). Journal of Surgical Oncology 107(2): 195-200, 2013

Impact of neoadjuvant chemotherapy and postoperative adjuvant chemotherapy cycles on survival of patients with advanced-stage ovarian cancer. Plos One 12(9): E0183754, 2017

Impact of obesity on chemotherapy dosing for women with advanced stage serous ovarian cancer in the Australian Ovarian Cancer Study (AOCS). Gynecologic Oncology 133(1): 16-22, 2014

Factors associated with delivery of neoadjuvant chemotherapy in women with advanced stage ovarian cancer. Gynecologic Oncology 148(1): 168-173, 2017

Impact of Hematopoietic Growth Factors on Blood Transfusion Needs, Incidence of Neutropenia, and Overall Survival Among Elderly Advanced Ovarian Cancer Patients Treated With Chemotherapy. International Journal of Gynecological Cancer 26(1): 95-103, 2016

Investigation of the timing of neoadjuvant chemotherapy on survival in advanced stage ovarian cancer. Gynecologic Oncology 137: 146-147, 2015

Impact of the time interval from completion of neoadjuvant chemotherapy to initiation of postoperative adjuvant chemotherapy on the survival of patients with advanced ovarian cancer. Gynecologic Oncology 148(1): 62-67, 2017

Prognostic Factors for Overall Survival in Elderly Patients With Advanced Ovarian Cancer Treated With Chemotherapy. Obstetric and Gynecologic Survey 72(1): 29-30, 2017

Use and duration of chemotherapy and its impact on survival in early-stage ovarian cancer. Gynecologic Oncology 137(2): 203-209, 2015

Efficacy of weekly low-dose chemotherapy in elderly women with advanced ovarian cancer: is there an antiangiogenic effect?. Journal of Clinical Oncology 24(18_Suppl): 13133-13133, 2016

Neoadjuvant chemotherapy before definite operative approach for women with advanced-stage epithelial ovarian cancer. Taiwanese Journal of Obstetrics and Gynecology 57(5): 623-624, 2018

Impact of increased utilization of neoadjuvant chemotherapy on survival in patients with advanced ovarian cancer: experience from a comprehensive cancer center. Journal of Gynecologic Oncology 29(4): E63, 2018

Impact of neoadjuvant chemotherapy on the survival of patients with stage IIIc and IV epithelial ovarian cancer. Zhonghua Zhong Liu Za Zhi 30(4): 298-301, 2008

Chemotherapy Dose Reduction and Delay are Associated with Worse Progression Free but not Overall Survival in Patients with Advanced Stage Ovarian Cancer. Gynecologic Oncology 107(2): 370-371, 2007

Neoadjuvant chemotherapy lessens surgical morbidity in advanced ovarian cancer and leads to improved survival in stage IV disease. Gynecologic Oncology 105(1): 211-217, 2007