Primary Treatment and Survival in Advanced-Stage Epithelial Ovarian Cancer: U.S. Trends
Posted: Tuesday, December 1, 2020
In a research letter published in JAMA Network Open, Alexander Melamed, MD, MPH, of NewYork-Presbyterian/Columbia University Irving Medical Center, New York, and colleagues examined and compared trends in the use of neoadjuvant chemotherapy and their effects on the median survival among women with advanced-stage epithelial ovarian cancer. They found that although the use of neoadjuvant chemotherapy is increasing in the United States, these trends do not seem to be associated with a change in median survival rates.
A total of 72,171 women were identified using the National Cancer Database. These women were classified as receiving chemotherapy, surgery, or both for stage IIIC or IV epithelial ovarian cancer. Gathered data were then used to calculate the proportion of women diagnosed each year who were treated with neoadjuvant chemotherapy, and the primary survival outcome was calculated as the time from diagnosis to death or last follow-up. Between 2004 and 2016, a total of 53,021 women were treated with primary cytoreductive surgery (73.5%), and 19,150 women were treated with neoadjuvant chemotherapy (26.5%).
Findings revealed that from 2004 to 2006, 17.6% of women received neoadjuvant chemotherapy, and that proportion did not change over that period (annual percentage change = 0.5%; 95% confidence interval [CI] = −1.3% to 2.4%; P = .54). Data revealed the frequency of primary chemotherapy increased by 7.9% (95% CI = 7.0%–8.7%) per year from 2006 to 2011 (P < .001) and by 10.3% (95% CI = 9.1%–11.5%) per year from 2011 to 2016 (P = .01). Although median survival increased from 31.1 months (95% CI = 29.9–32.3 months) in 2004 to 37.8 months (95% CI = 36.4–38.8 months) in 2013, increased use of neoadjuvant chemotherapy did not appear to be associated with increasing median survival trends (P = .37).
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.
