Journal of Clinical Oncology, 2004 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 22, No 14S (July 15 Supplement), 2004: 5083
© 2004 American Society of Clinical Oncology

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Abstract

Poor prognosis of taxane/platinum treated advanced stage ovarian cancer patients despite a negative second look laparotomy

University of Alabama at Birmingham, Birmingham, AL

5083

Background: Previous studies in taxane/platinum treated patients have shown recurrence rates of 50% in all stages after a negative second look laparotomy (SLL); however, they failed to specifically address recurrence rates in advanced stages after negative SLL. This study assessed the risk of recurrence of advanced stage epithelial ovarian cancer patients after complete response to taxane/platinum-based chemotherapy. Methods: Patients with epithelial ovarian cancer treated with taxane/platinum-based chemotherapy from 1994 - 2001 were identified from the medical records. Complete response was defined as having pathologically negative SLL with a post-treatment CA125 of <35 IU. Survival analysis and comparisons were performed using the Kaplan-Meier method and the log rank test. Results: Sixty-six patients with a negative SLL and normal post-treatment CA125 were identified. 37 of the 66 patients (56%) with a negative SLL recurred, and specfically 31 of 43 (72%) stage IIIc/IV patients recurred. Five-year disease free survival (DFS) for stages IIIc/IV was significantly worse than stage I-IIIb (25% vs. 63%, p=0.02). Five-year overall survival was 61% and 87% (p=0.13) for stage IIIc/IV and stage I-IIIb, respectively. Median DFS of stage IIIc/IV was 27 months with a median time to recurrence of 16 months (range 4–61 months). Median follow-up of survivors after SLL was 47 months. Subgroup analysis revealed no significant risk factors for recurrence. Conclusions: Taxane/platinum treated stage IIIc/IV patients who have a negative SLL have high rates of recurrence (72%). Despite complete response to primary therapy, advanced stage disease at initial diagnosis confers a poor prognosis. This data would further substantiate abandonment of second look laparotomy and the investigation of maintenance therapies in this population.

No significant financial relationships to disclose.

Abstract presentation from the 2004 ASCO Annual Meeting