title: The association between timing of initiation of adjuvant therapy and the survival of early stage ovarian cancer patients - An analysis of NRG Oncology/Gynecologic Oncology Group trials.
abstract: OBJECTIVE
  To determine the association between timing of adjuvant therapy initiation and survival of early stage ovarian cancer patients.
  
  
  METHODS
  Data were obtained from women who underwent primary surgical staging followed by adjuvant therapy from two Gynecologic Oncology Group trials (protocols # 95 and 157). Kaplan-Meier estimates and Cox proportional hazards model adjusted for covariates were used for analyses.
  
  
  RESULTS
  Of 497 stage I-II epithelial ovarian cancer patients, the median time between surgery and initiation of adjuvant therapy was 23days (25th-75th%: 12-33days). The time interval from surgery to initiation of adjuvant therapy was categorized into three groups: <2weeks, 2-4weeks, and >4weeks. The corresponding 5-year recurrence-free survival rates were 72.8%, 73.9%, and 79.5% (p=0.62). The 5-year overall survival rates were 79.4%, 81.9%, and 82.8%, respectively (p=0.51; p=0.33 - global test). As compared to <2weeks, the hazard ratio for recurrence-free survival was 0.90 (95%CI=0.59-1.37) for 2-4weeks and 0.72 (95%CI=0.46-1.13) for >4weeks. Age, stage, grade, and cytology were important prognostic factors.
  
  
  CONCLUSIONS
  Timing of adjuvant therapy initiation was not associated with survival in early stage epithelial ovarian cancer patients.
authors: Division of Gynecologic Oncology, California Pacific-Palo Alto Medical Foundation Sutter Research Institute, 3838 California Street #410, San Francisco, CA 94115, United States. Electronic address: chanjohn@sutterhealth.org.
authors: John K
authors: JK
authors: Chan
authors: NRG Oncology/Gynecologic Oncology Group Statistics & Data Center, Roswell Park Cancer Institute, Buffalo, NY 14263, United States. Electronic address: james.j.java@gmail.com.
authors: James J
authors: JJ
authors: Java
authors: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University, School of Medicine, St. Louis, MO 63108, United States. Electronic address: kfuh@wudosis.wustl.edu.
authors: Katherine
authors: K
authors: Fuh
authors: Division of Gynecologic Oncology, University of Arizona Cancer Center, Creighton University School of Medicine, and St. Joseph's Hospital and Medical Center, 500 W. Thomas Road, suite 660, Phoenix, AZ 85013, United States. Electronic address: bradley.monk@dignityhealth.org.
authors: Bradley J
authors: BJ
authors: Monk
authors: Department of Radiation Oncology, Stanford University School of Medicine, 875 Blake Wilbur Drive, Stanford, CA 94305, United States. Electronic address: dskapp@stanford.edu.
authors: Daniel S
authors: DS
authors: Kapp
authors: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Cincinnati Cancer Institute, Health Professions Building Suite, 3255 Eden Avenue, Cincinnati, OH 45267-0662, United States. Electronic address: herzogtj@ucmail.uc.edu.
authors: Thomas
authors: T
authors: Herzog
authors: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Ohio State University, Riverside Methodist Hospital, Columbus, OH 43210, United States. Electronic address: jeff.bell@ohiohealth.com.
authors: Jeffrey
authors: J
authors: Bell
authors: Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111, United States. Electronic address: robert.young@fccc.edu.
authors: Robert
authors: R
authors: Young
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000188:drug therapy* / Q000473:pathology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D016190:Carboplatin / Q000008:administration & dosage; D018269:Carcinoma, Endometrioid / Q000188:drug therapy* / Q000473:pathology; D000077216:Carcinoma, Ovarian Epithelial; D017024:Chemotherapy, Adjuvant / Q000379:methods*; D002945:Cisplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D065426:Cytoreduction Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007263:Infusions, Parenteral; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; 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; D015996:Survival Rate; D013997:Time Factors
chemical_list: D003520:Cyclophosphamide; D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin
keywords: Early stage ovarian cancer; Prognosis; Survival