Predictive Factors Involved in Determining response to Neoadjuvant Chemotherapy in High Grade Serous ovarian cancer and impact of response on 5 years disease free survival and overall survival
Zainab Zubair, Somer Masood, Shahid Khattak, Aamer Ali Syed
638
ABSTRACT
Aim: To evaluate all
the known factors that may play a role in predicting response to chemotherapy
and to see impact of response on five years’ disease free survival (DFS) and
overall survival (OS).
Methods: Data of 156
patients was reviewed retrospectively from January 2012 to December 2012 at
Shaukat Khanum Memorial Cancer Hospital and Research Centre Lahore, Pakistan. All received neoadjant chemotherapy (NAC)and
had no distant metastasis. The response was measured in term of percentage ureduction
from 1st radiological size on presentation to final size on
histopathology (on resected specimen). Four groups were identified, complete
responder (CR) (100% reduction),Responders (R) (>50% reduction),Partial
responder (PR) (<50% reduction) and Non-responder (NR)..
Results: Median
age of patients was 45 years (25-64 years). 67% of patient underwent debulking
surgery on ovarian protocol without pelvic node dissection. Mortality for whole
group was 22%, and recurrence was shown in 34%(Majority 26% were distant). Out of 156 patients, 25% of patients were CR,
13% were NR, 23% were PR and 37% were R. Progesterone receptor negative and
Grade III tumors showed more complete responses. The Rest of the factors,
including, initial T and N stage and other factors showed no impact on
chemo-response. Survival was significantly poor in NR group (45% OS, 40% DFS),
while rest of three groups had comparable survival outcome, with CR group
having best survival outcome (86% OS, 80% DFS).
Conclusion: Most of factors studied did not show impact on achieving good chemo
response, however good chemo response did show better survival.
Keywords: Neo-adjuvant
chemotherapy, Response of neo-adjuvant, serous ovarian carcinoma,
ABSTRACT
Aim: To evaluate all
the known factors that may play a role in predicting response to chemotherapy
and to see impact of response on five years’ disease free survival (DFS) and
overall survival (OS).
Methods: Data of 156
patients was reviewed retrospectively from January 2012 to December 2012 at
Shaukat Khanum Memorial Cancer Hospital and Research Centre Lahore, Pakistan. All received neoadjant chemotherapy (NAC)and
had no distant metastasis. The response was measured in term of percentage ureduction
from 1st radiological size on presentation to final size on
histopathology (on resected specimen). Four groups were identified, complete
responder (CR) (100% reduction),Responders (R) (>50% reduction),Partial
responder (PR) (<50% reduction) and Non-responder (NR)..
Results: Median
age of patients was 45 years (25-64 years). 67% of patient underwent debulking
surgery on ovarian protocol without pelvic node dissection. Mortality for whole
group was 22%, and recurrence was shown in 34%(Majority 26% were distant). Out of 156 patients, 25% of patients were CR,
13% were NR, 23% were PR and 37% were R. Progesterone receptor negative and
Grade III tumors showed more complete responses. The Rest of the factors,
including, initial T and N stage and other factors showed no impact on
chemo-response. Survival was significantly poor in NR group (45% OS, 40% DFS),
while rest of three groups had comparable survival outcome, with CR group
having best survival outcome (86% OS, 80% DFS).
Conclusion: Most of factors studied did not show impact on achieving good chemo
response, however good chemo response did show better survival.
Keywords: Neo-adjuvant
chemotherapy, Response of neo-adjuvant, serous ovarian carcinoma,