title: Does time interval between surgery and intraperitoneal chemotherapy administration in advanced ovarian cancer carry a prognostic impact? An NRG Oncology/Gynecologic Oncology Group study ancillary study.
abstract: OBJECTIVE
  To determine the relationship of the time from surgery to intraperitoneal (IP) chemotherapy (TSIC) initiation with survival of patients with stage III epithelial ovarian cancer (EOC) patients using ancillary data from cooperative group clinical trials.
  
  
  METHODS
  Data from 420 patients with stage III EOC treated with IP chemotherapy under GOG-0114 and 172 were reviewed. The Cox proportional hazards model was used to evaluate independent prognostic factors and estimate their covariate-adjusted effects on PFS and OS.
  
  
  RESULTS
  The median TSIC was 62.5days (interquartile range 28-83). The median TSIC was longer for patients in GOG-0114 vs those in GOG-172 (83 vs 26days, p<0.001). TSIC was significantly associated (p=0.049) with PFS: each 10% increase in TSIC (days) decreases the risk of progression by 3%. TSIC was not significantly associated with OS in this model. In a linear regression model, gross residual disease was significantly associated with shorter TSIC (R2-0.141, 95%CI -0.217, -0.064, p<0.001). When only data from GOG-172 were considered, no statistical significant association was found between TSIC and PFS or OS.
  
  
  CONCLUSIONS
  In this ancillary data study, TSIC was not associated with improved OS in patients with stage III epithelial ovarian cancer. TSIC was significantly associated with PFS for the entire cohort, suggesting increase in PFS with longer TSIC. However, this was not found when only data from GOG 172 or GOG 114 were analyzed separately. Hence, the relationship between IP chemotherapy initiation and time from surgery needs to be studied further.
authors.affiliation: Division of Gynecology Oncology, Department of OB-GYN, University of Miami Miller School of Medicine, Miami, FL, United States. Electronic address: Arlene_e_garcia@hotmail.com.
authors.forename: Arlene E
authors.initials: AE
authors.lastname: Garcia-Soto
authors.affiliation: NRG Statistics and Data Management Center, Roswell Park Cancer Institute, Buffalo, NY, United States. Electronic address: james.j.java@gmail.com.
authors.forename: James J
authors.initials: JJ
authors.lastname: Java
authors.affiliation: Division of Gynecology Oncology, Department of OB-GYN, University of Miami Miller School of Medicine, Miami, FL, United States. Electronic address: nwilberto@hotmail.com.
authors.forename: Wilberto
authors.initials: W
authors.lastname: Nieves Neira
authors.affiliation: Division of Gynecology Oncology, Department of OB-GYN, University of Miami Miller School of Medicine, Miami, FL, United States. Electronic address: mpearson@med.miami.edu.
authors.forename: J Matthew
authors.initials: JM
authors.lastname: Pearson
authors.affiliation: The Ohio State University, Columbus, OH, United States. Electronic address: David.Cohn@osumc.edu.
authors.forename: David E
authors.initials: DE
authors.lastname: Cohn
authors.affiliation: Gynecologic Oncology, Roswell Park Cancer Institute, Buffalo, NY, United States. Electronic address: Shashi.Lele@RoswellPark.org.
authors.forename: Shashikant B
authors.initials: SB
authors.lastname: Lele
authors.affiliation: Obstetrics-Gynecology, University of California, Irvine, Orange, CA, United States. Electronic address: ktewari@uci.edu.
authors.forename: Krishnansu S
authors.initials: KS
authors.lastname: Tewari
authors.affiliation: Gynecologic Oncology, Peggy and Charles Stephenson Oklahoma Cancer Center, Oklahoma City, OK, United States. Electronic address: joan-walker@ouhsc.edu.
authors.forename: Joan L
authors.initials: JL
authors.lastname: Walker
authors.affiliation: Gynecologic Oncology, Duke Medical Center, Durham, NC, United States. Electronic address: angeles.secord@duke.edu.
authors.forename: Angeles
authors.initials: A
authors.lastname: Alvarez Secord
authors.affiliation: Gynecology and Obstetrics, Johns Hopkins Kimmel Cancer Center, Baltimore, MD, United States. Electronic address: ARMSTDE@jhmi.ed.
authors.forename: Deborah K
authors.initials: DK
authors.lastname: Armstrong
authors.affiliation: The Ohio State University, Columbus, OH, United States. Electronic address: larry.copeland@osumc.edu.
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Copeland
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000188:drug therapy* / Q000473:pathology; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D018269:Carcinoma, Endometrioid / Q000188:drug therapy* / Q000473:pathology; D000077216:Carcinoma, Ovarian Epithelial; D017024:Chemotherapy, Adjuvant / Q000379:methods*; D065426:Cytoreduction Surgical Procedures; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000188:drug therapy* / Q000473:pathology; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy* / Q000473:pathology; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology; D017239:Paclitaxel / Q000008:administration & dosage*; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents; D017239:Paclitaxel
keywords: NRG Oncology; Ovarian cancer; Time interval between surgery and IP chemo