Prognostic Impact of the Time Interval between Surgery and Postoperative Adjuvant Chemotherapy in Epithelial Carcinoma of the Ovary

Abstract

Introduction: Multiple studies have evaluated the prognostic impact of the time interval (TI) between initial surgery and adjuvant chemotherapy for epithelial ovarian cancer with different time intervals and inconclusive results. The aim of the present study was to evaluate the prognostic impact of a longer interval of 42 days. Methods: In a retrospective single-centre analysis, data were collected for all patients with epithelial ovarian cancer treated between 2007 and 2014. We divided patients by TI: ≤42 days and >42 days. The disease-free survival and overall survival (OS) between the two groups were compared. A Cox regression model was used to evaluate different prognostic factors. A p value <0.05 was considered statistically significant. Results: The median follow-up time was 73 months. Among those with postoperative residual disease (n = 30), TI of >42 days was associated with significantly worse OS (hazard ratio = 3.37, 95% confidence interval = 1.23-9.25, p = 0.02). In cases with residual disease after surgery, the Cox proportional model showed the presence of ascites (p = 0.03) and postoperative CA125 level (p = 0.03) were independent prognostic factors for DFS. TI >42 days (p = 0.03) was an independent negative prognostic factor for OS along with grading (p = 0.05) and presence of ascites (p < 0.01). Conclusion: Our study showed that patients with residual disease after initial surgery had inferior OS when TI was >42 days. Adjuvant chemotherapy in these patients should be started ≤42 days after surgery.