Treatment Outcomes of Epithelial Ovarian Cancers Following Maximum Cytoreduction and Adjuvant Paclitaxel-Carboplatin Chemotherapy: Egyptian NCI Experience


Background: Epithelial ovarian cancer (EOC) is the commonest malignancy involving the ovaries. Maximumsurgical cytoreduction (MCR) followed by adjuvant taxane-platinum chemotherapy are the standard of caretreatments. Aims: To study treatment outcomes of EOC patients that were maximally cyto-reduced and receivedadjuvant paclitaxel-carboplatin (PC) chemotherapy. Materials and
Methods: This retrospective cohort studyincluded 174 patients with EOC treated at the Egyptian National Cancer Institute between 2006 and 2010. Forinclusion, they should have had undergone MCR with no-gross residual followed by adjuvant PC chemotherapy.MCR was total abdominal hysterectomy/bilateral salpingo-oophorectomy [TAH/BSO] or unilateral salpingooophorectomy[USO] plus comprehensive staging.
Results: The median age was 50 years. Most patients weremarried (97.1%), had offspring (92.5%), were postmenopausal (53.4%), presented with abdominal/pelvic painand swelling (93.7%), had tumors involving both ovaries (45.4%) without extra-ovarian extension i.e. stage I(55.2%) of serous histology (79.9%) and grade II (87.4%). TAH/BSO was performed in 97.7% of cases. A total of1,014 PC chemotherapy cycles were administered and were generally tolerable with 93.7% completing 6 cycles.Alopecia and numbness were the commonest adverse events. The median follow up period was 42 months. The2-year rates for disease free survival (DFS) and overall survival (OS) were 70.7% and 94.8%, respectively. Therespective 5-year rates were 52.6% and 81.3%. Advanced stage and high-grade were significantly associatedwith poor DFS and OS (p<0.001). Age >65 years was associated with poor OS (p =0.008). Using Cox-regression,stage was independent predictor of poor DFS and OS. Age was an independent predictor of poor OS.