NACT use up from 2003 to 2012; linked to shorter overall survival in stage IIIC but not stage IV disease
MONDAY, Sept. 12, 2016 (HealthDay News) — For patients with stage IIIC to IV ovarian cancer, neoadjuvant chemotherapy (NACT) use increased from 2003 to 2012, according to a study published online Sept. 6 in the Journal of Clinical Oncology.
Larissa A. Meyer, M.D., from the University of Texas MD Anderson Cancer Center in Houston, and colleagues examined the use of NACT versus primary cytoreductive surgery (PCS) in a multi-center observational study. Data were included for 1,538 women with stages IIIC to IV ovarian cancer who were diagnosed between 2003 and 2012. Overall survival, morbidity, and postoperative residual disease were compared in a propensity-score matched sample of 594 patients.
The researchers found that from 2003-2010 to 2011-2012 there was an increase in NACT use from 16 to 34 percent in stage IIIC disease and from 41 to 62 percent in stage IV disease (both Ptrend < 0.001). There was variation by institution in adoption of NACT, from 8 to 30 percent for stage IIIC disease (P < 0.001) and from 27 to 61 percent for stage IV disease (P = 0.007). NACT correlated with shorter overall survival in stage IIIC disease compared with PCS (hazard ratio, 1.40; 95 percent confidence interval, 1.11 to 1.77), but not in stage IV disease (hazard ratio, 1.16; 95 percent confidence interval, 0.89 to 1.52).
“Future studies should prospectively consider the efficacy of NACT by extent of residual disease in unselected patients,” the authors write.
Several authors disclosed financial ties to the biopharmaceutical industry.
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