title: Three versus six cycles of adjuvant platinum-based chemotherapy in early stage clear cell ovarian carcinoma - A multi-institutional cohort.
abstract: OBJECTIVE
  To determine if 6 versus 3cycles of adjuvant platinum-based chemotherapy with or without taxane impacts survival in early stage ovarian clear cell carcinoma (OCCC).
  
  
  METHODS
  We retrospectively identified all cases of stage I and II OCCC treated at 5 institutions from January 1994 through December 2011. Patients were divided into 2 groups: those who received 3 versus 6cycles of adjuvant chemotherapy. Our cohort consisted of 210 patients with stage IA-II disease, 116 of whom underwent full surgical staging. Cox proportional hazards regression and Kaplan-Meier analyses were performed to evaluate progression-free (PFS) and overall survival (OS) between groups.
  
  
  RESULTS
  Among 210 eligible patients, the median age was 53years (range 30-88). The majority of patients were Caucasian (83.8%). All patients received adjuvant chemotherapy with 90% receiving carboplatin and paclitaxel. Thirty-eight (18.1%) patients received 3cycles, and 172 (81.9%) patients received 6cycles of adjuvant treatment. Recurrence rate was comparable between groups (18.4% vs. 27.3% for 3 vs. 6cycles, p=0.4). There was no impact of 3 versus 6cycles of chemotherapy on PFS (hazard ratio [HR] 1.4; 95% confidence interval [CI] 0.63-3.12, p=0.4) or OS (HR 1.65; 95% CI 0.59-4.65, p=0.3) on univariate analysis. There was no benefit to more chemotherapy in stratified analysis by stage nor on multivariate analysis adjusting for the impact of stage. Subgroup analysis of surgically staged patients also showed no difference in survival between 3 versus 6cycles of chemotherapy.
  
  
  CONCLUSIONS
  Three cycles of platinum with or without taxane adjuvant chemotherapy were comparable to 6cycles with respect to recurrence and survival in patients diagnosed with early stage ovarian clear cell carcinoma in this retrospective multi-institutional cohort.
  
  
  CONCLUSIONS
  Three cycles of platinum with or without taxane adjuvant chemotherapy are comparable to 6 cycles with respect to recurrence and survival in patients diagnosed with early stage ovarian clear cell carcinoma in this retrospective multi-institutional cohort.
authors.affiliation: Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Emily N
authors.initials: EN
authors.lastname: Prendergast
authors.affiliation: Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Marie
authors.initials: M
authors.lastname: Holzapfel
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Mueller
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Mario M
authors.initials: MM
authors.lastname: Leitao
authors.affiliation: Stephenson Oklahoma Cancer Center at the University of Oklahoma, Oklahoma City, OK, USA.
authors.forename: Camille C
authors.initials: CC
authors.lastname: Gunderson
authors.affiliation: Stephenson Oklahoma Cancer Center at the University of Oklahoma, Oklahoma City, OK, USA.
authors.forename: Kathleen N
authors.initials: KN
authors.lastname: Moore
authors.affiliation: University of Alabama at Birmingham, AL, USA.
authors.forename: Britt K
authors.initials: BK
authors.lastname: Erickson
authors.affiliation: University of Alabama at Birmingham, AL, USA.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Leath
authors.affiliation: Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Elena S
authors.initials: ES
authors.lastname: Diaz Moore
authors.affiliation: University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: Joshua G
authors.initials: JG
authors.lastname: Cohen
authors.affiliation: Cedars-Sinai Medical Center, Los Angeles, CA, USA. Electronic address: walshc@cshs.org.
authors.forename: Christine S
authors.initials: CS
authors.lastname: Walsh
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D010984:Platinum / Q000627:therapeutic use; D012189:Retrospective Studies
chemical_list: D010984:Platinum
keywords: Chemotherapy; Clear cell; Early stage; Ovarian cancer; Survival