Correlation Analysis Of Age And Prognosis Of Ovarian Cancer

Purpose: The survival duration of elderly patients with epithelial ovarian carcinoma is shorter than that of their younger counterparts.This variation in survival duration is likely attributed to differences in the distribution of histological type or grade,International Federation of Gynecology and Obstetrics(FIGO)staging,and undertreatment,but this observation remains controversial.This study aimed to investigate the biological factors other than selection bias associated with the decreased survival of elderly patients with ovarian carcinoma.Methods: A total of 314 serous ovarian cancer(SOC)patients from Jiangsu Institute of Cancer Research(JICR,PRC)between 2002 and 2012 were retrospectively analyzed.The 8-hydroxy-2?-deoxyguanine(8-OHd G)concentration in leukocyte DNA was evaluated in 100 patients by using commercially available enzyme-linked immunosorbent assay kits,and tissue expression was assayed in 76 patients through immunohistochemistry.The associations between survival durations and covariates were assessed by using a Cox proportional hazards model and by conducting a log-rank test.Results: Advanced age ? 65 years was correlated with high histological grade(P=0.02),performance status(P=0.03),primary treatment(P<0.001),and suboptimal surgery outcome(P=0.04)in SOC patients from JICR.Age,FIGO stage,histological grade,and optimal surgery were independently associated with the progression-free survival(PFS;P=0.03,P=0.03,P=0.02,and P=0.04,respectively)and overall survival(OS;P=0.02,P=0.04,P=0.02,and P=0.02,respectively)of the SOC patients from JICR.The 8-OHd G concentration in the leukocyte DNA was higher in the elderly patients than in the younger cases.The high 8-OHd G concentration in the leukocyte DNA indicated poorer median OS(30.0 months,confidence interval [CI]: 23.5–36.5 vs.42.8 months,[CI] 38.3–47.2)and PFS(14.6months,[CI] 11.9–17.2 vs.18.9 months,[CI] 14.4–23.4)than those of their corresponding counterparts in the SOC patients who achieved a clinical complete response from primary treatment.Conclusions: Compared with younger cases,elderly patients with SOC were commonly characterized by high tumor grade,poor performance status,and undertreatment.Age is an independent risk factor affecting the prognosis of serous ovarian cancer? High 8-OHd G concentration in leukocyte DNA was associated with advanced age and poor prognosis in SOC patients.And High 8-OHd G may become a new marker for predicting the prognosis of ovarian cancer.Objective:No consensus exists on the number of chemotherapy cycles to be administered before and after interval debulking surgery(IDS)in patients with advanced stage epithelial ovarian cancer.The present study aims to explore the optimal number of cycles of neoadjuvant chemotherapy(NAC)and post-operation chemotherapy to treat the International Federation of Gynecology and Obstetrics stage IIIc–IV high-grade serous ovarian cancer(HG-SOC).Materials and Methods: A total of 129 IIIC–IV stage HG-SOC cases were retrospectively analyzed.Cases were comprised of patients who underwent NAC followed by IDS and who achieved clinical complete response(CCR)at the end of primary therapy.Patients were recruited from the Jiangsu Institute of Cancer Research between 1993 and 2013.Optimal IDS-associated factors were explored with logistic regression.The association between progression free survival(PFS),overall survival(OS)duration,and covariates was assessed by Cox proportional hazards model and log-rank test.Results: The median number of NAC cycle was 3(range1–8).CA-125 decreasing kinetics(P=0.01)was independently associated with optimal IDS.CA-125 decreasing kinetics,optimal IDS,and NAC cycles was independently associated with OS(P<0.01,P<0.01,P=0.03,respectively)and PFS(P<0.01,P<0.01,P= 0.04,respectively).The PFS of patients who underwent?5 NAC cycles was shorter than those of patients who underwent<5 NAC cycles(12.3 versus 17.2 months).The PFS and OS of patients who underwent<5 cycles of adjuvant chemotherapy post-IDS were shorter than those of patients who underwent ?5 cycles(14.2 and 20.3 versus21.2 and 28.8 months).Conclusion :NAC cycles,CA-125 decreasing kinetics,and optimal debulking are independently associated with the prognosis of patients with advanced stage HG-SOC who underwent NAC/IDS and achieved CCR.The number of administered NAC cycles should not exceed 4.