Predicting Long-Term Prognoses and Grading Platinum Sensitivity Using a Novel Progression-Free Interval Criterion in Ovarian Clear Cell Carcinoma: A Multi-Institutional Cohort Study.
Cheng-Yang ChouWen-Fang ChengMin-Yu ChenHao LinChih-Ming HoYao-Ching HungLee-Wen HuangPo-Hui WangMu-Hsien YuYu-Fang HuangPublished in: Cancers (2022)
This large-scale study aimed to determine the long-term influences of potential prognostic predictors and progression-free interval (PFI) criteria for grading platinum-sensitivity in ovarian clear cell carcinoma (OCCC). We retrospectively reviewed the medical records of OCCC patients presenting at nine tertiary centres (1995-2015), and evaluated patient characteristics, therapeutic factors, clinical outcomes, and hazard ratios for disease progression and death. We enrolled 536 patients (median follow-up, 36.6 months) and developed newly defined distributions of PFIs (seven and 14 months) for grading platinum sensitivity. In the multivariate model, preoperative CA125 levels and chemo-response independently predicted early-stage progression-free survival (PFS) risk. Post-progression cytoreduction correlated with reduced mortality risk. No unfavourable outcomes were observed with respect to coexisting endometriosis, fertility-sparing strategies, or platinum-based regimens. A PFI of <7 months, the strongest predictor of both post-progression mortality and second relapse risks, correlated with chemo-resistance, advanced tumour stage, and shortened post-progression survival. Chemotherapy regimens commonly used in front-line or relapse settings were limited in improving prognoses, especially in the advanced-stage cohort. Clinical trials of novel targeted agents and/or innovative biomarkers for chemoresistance should be comprehensively investigated and offered early to advanced-stage patients or those with OCCC progression occurring within seven months after receiving chemotherapy.
Keyphrases
- end stage renal disease
- free survival
- early stage
- ejection fraction
- newly diagnosed
- chronic kidney disease
- prognostic factors
- healthcare
- cancer therapy
- case report
- adipose tissue
- photodynamic therapy
- cardiovascular disease
- skeletal muscle
- cardiovascular events
- risk assessment
- young adults
- insulin resistance
- study protocol
- patient reported
- human health
- open label
- phase ii