title: A risk-adapted strategy of adjuvant paclitaxel/carboplatin in early-stage ovarian cancer: time-dependent effect of 4 versus 6 cycles on outcome.
abstract: OBJECTIVE
  We investigated the efficacy of risk-adapted adjuvant paclitaxel/carboplatin chemotherapy in early-stage ovarian carcinoma.
  
  
  METHODS
  Fifty-three patients were treated according to the risk of relapse: patients with stages IA or IB or with grade 1 (low risk) received 4 cycles of paclitaxel and carboplatin; patients with IC/IIA and grade 2 or 3 (high risk) received 6 cycles of chemotherapy. The outcome was compared with that of 95 patients who were all treated with 4 cycles.
  
  
  RESULTS
  Median follow-up was 88, 113 and 42 months for the whole cohort, non-risk-adapted and risk-adapted treatment, respectively. Five-year relapse-free and disease-specific survival was 86 and 93% for the whole population, 96 and 97% for low-risk and 81 and 91% for high-risk patients. Risk classification was the only significant prognostic factor for relapse-free (p = 0.011) and disease-specific survival (p = 0.039). Among high-risk patients, the administration of 6 cycles was associated with a significantly lower relapse rate after censoring events, which occurred beyond 2 years (3 vs. 18%; p = 0.013), but this difference was diminished at 5 years (23 vs. 25%; p = 0.797).
  
  
  CONCLUSIONS
  Six cycles of chemotherapy reduced the risk of relapse within 2 years, but the benefit from two additional cycles beyond this time is questionable.
authors.affiliation: Department of Clinical Therapeutics, University of Athens, Athens, Greece. abamias@med.uoa.gr
authors.forename: Aristotle
authors.initials: A
authors.lastname: Bamias
authors.forename: Christina
authors.initials: C
authors.lastname: Bamia
authors.forename: Alexandra
authors.initials: A
authors.lastname: Karadimou
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Soupos
authors.forename: Flora
authors.initials: F
authors.lastname: Zagouri
authors.forename: Alexandros
authors.initials: A
authors.lastname: Rodolakis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Haidopoulos
authors.forename: George
authors.initials: G
authors.lastname: Vlahos
authors.forename: Nikos
authors.initials: N
authors.lastname: Thomakos
authors.forename: Aristidis
authors.initials: A
authors.lastname: Antsaklis
authors.forename: Meletios A
authors.initials: MA
authors.lastname: Dimopoulos
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D016190:Carboplatin / Q000008:administration & dosage; D002277:Carcinoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000473:pathology / Q000517:prevention & control; D009367:Neoplasm Staging / Q000379:methods; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology; D017239:Paclitaxel / Q000008:administration & dosage; D011379:Prognosis; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D016190:Carboplatin; D017239:Paclitaxel