title: Hormonal Maintenance Therapy for Women With Low-Grade Serous Cancer of the Ovary or Peritoneum.
abstract: Purpose The purpose of this study was to examine outcomes associated with hormonal maintenance therapy (HMT) compared with routine observation (OBS) after primary cytoreductive surgery and platinum-based chemotherapy in women with stage II to IV low-grade serous carcinoma of the ovary or peritoneum. Patients and Methods Eligibility criteria for patients from our database were: treatment with primary surgery followed by platinum-based chemotherapy, stage II to IV disease, at least 2 years of follow-up for patients who had not experienced recurrence, and adequate clinical information. The two groups were compared for progression-free survival (PFS) and overall survival, and a multivariable Cox regression analysis was performed. Subset analyses for patients who were disease free or had persistent disease were also performed. Results Between 1981 and 2013, 203 eligible patients-133 who underwent OBS and 70 who received HMT-were seen at our institution. Median PFS for patients who underwent OBS was 26.4 months, compared with 64.9 months for those who received HMT ( P < .001). No statistically significant difference in overall survival was observed between the two groups (102.7 v 115.7 months, respectively). For subgroups of women who were disease free or had persistent disease, median PFS was superior for those who received HMT (81.1 v 30.0 months; P < .001 and 38.1 v 15.2 months; P < .001, respectively). Women who received HMT had a significantly lower risk of disease progression compared with those who underwent OBS (hazard ratio, 0.44; 95% CI, 0.31 to 0.64; P < .001). Conclusion Women with stage II to IV low-grade serous carcinoma who received HMT after primary treatment had significantly longer PFS compared with women who underwent OBS. These findings warrant further investigation using a prospective trial design.
authors.affiliation: All authors: University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: David M
authors.initials: DM
authors.lastname: Gershenson
authors.affiliation: All authors: University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Diane C
authors.initials: DC
authors.lastname: Bodurka
authors.affiliation: All authors: University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Coleman
authors.affiliation: All authors: University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Karen H
authors.initials: KH
authors.lastname: Lu
authors.affiliation: All authors: University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Anais
authors.initials: A
authors.lastname: Malpica
authors.affiliation: All authors: University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Charlotte C
authors.initials: CC
authors.lastname: Sun
mesh_terms: D000328:Adult; D000368:Aged; D000077384:Anastrozole; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D065426:Cytoreduction Surgical Procedures; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000077289:Letrozole; D016729:Leuprolide / Q000008:administration & dosage; D060046:Maintenance Chemotherapy; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000473:pathology / Q000628:therapy*; D009570:Nitriles / Q000008:administration & dosage; D010051:Ovarian Neoplasms / Q000473:pathology / Q000628:therapy*; D010534:Peritoneal Neoplasms / Q000473:pathology / Q000628:therapy*; D017671:Platinum Compounds / Q000008:administration & dosage; D015996:Survival Rate; D013629:Tamoxifen / Q000008:administration & dosage; D014230:Triazoles / Q000008:administration & dosage; D057832:Watchful Waiting; D055815:Young Adult
chemical_list: D009570:Nitriles; D017671:Platinum Compounds; D014230:Triazoles; D013629:Tamoxifen; D000077384:Anastrozole; D000077289:Letrozole; D017258:Medroxyprogesterone Acetate; D016729:Leuprolide