Chemotherapeutic Regimens and Chemotherapy-Free Intervals Influence the Survival of Patients with Recurrent Advanced Epithelial Ovarian Carcinoma: A Retrospective Population-Based Study

Hsin-Ying Huang, Chun-Ju Chiang, Yun-Yuan Chen, San-Lin You, Heng-Cheng Hsu, Chao-Hsiun Tang and Wen-Fang Cheng
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Hsin-Ying Huang: School of Health Care Administration, Taipei Medical University, Taipei 106, Taiwan
Chun-Ju Chiang: Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 100, Taiwan
Yun-Yuan Chen: Taiwan Blood Services Foundation, Taipei 100, Taiwan
San-Lin You: School of Medicine, College of Medicine and Big Data Research Centre, Fu-Jen Catholic University, New Taipei City 242, Taiwan
Heng-Cheng Hsu: National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu City 300, Taiwan
Chao-Hsiun Tang: School of Health Care Administration, Taipei Medical University, Taipei 106, Taiwan
Wen-Fang Cheng: Graduate Institute of Clinical Medicine, National Taiwan University, Taipei 100, Taiwan

IJERPH, 2021, vol. 18, issue 12, 1-13

Abstract: We aimed to evaluate factors influencing the outcomes of patients with platinum-sensitive recurrent epithelial ovarian carcinoma (EOC). Patients with advanced-stage EOC, who received debulking surgery and adjuvant chemotherapy for recurrence, were obtained from the National Health Insurance Research database of Taiwan between 2000 and 2013. A total of 1038 patients with recurrent advanced-stage EOC were recruited. The platinum + paclitaxel (PT) group had the best five-year overall survival (OS) compared with the other three groups ( p < 0.001). The hazard ratios (HRs) of five-year OS for the platinum + liposomal doxorubicin (PD), topotecan (TOP), and pegylated liposomal doxorubicin (PLD) groups were 1.21 ( p = 0.07), 1.35 ( p = 0.016), and 1.80 ( p < 0.001), respectively, compared with the PT group. The PT group also had lower hazard ratios of five-year OS for patients with platinum therapy-free interval (TFIp) between 6 and 12 months compared with the other three groups ( p < 0.0001). However, the HRs of five-year OS did not differ between the PT and PD groups in patients with TFIp >12 months. Patients with TFIp >12 months had lower HRs of five-year OS compared with those with TFIp of 6–12 months, regardless of whether they were treated with platinum-based ( p = 0.001) or non-platinum-based ( p = 0.003) regimens. Chemotherapeutic regimens and TFIp influenced the outcomes of patients with recurrent EOC. For patients with TFIp of 6–12 months, the PT regimen is the first choice based on their best overall survival result. For patients with TFIp >12 months, either platinum-based or non-platinum regimens could be used because of their similar excellent overall survival.

Keywords: ovarian carcinoma; recurrence; paclitaxel; liposomal doxorubicin; topotecan; chemotherapy-free interval (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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