J Gynecol Oncol.  2014 Jan;25(1):43-50. 10.3802/jgo.2014.25.1.43.

Survival benefit of taxane plus platinum in recurrent ovarian cancer with non-clear cell, non-mucinous histology

• Kajiyama H
• Shibata K
• Mizuno M
• Umezu T
• Suzuki S
• Sekiya R
• Niimi K
• Mitsui H
• Yamamoto E
• Kawai M
• Nagasaka T
• Kikkawa F

• KMID: 1811187
• DOI: http://doi.org/10.3802/jgo.2014.25.1.43

Abstract

OBJECTIVE
This study was conducted to examine the effects of front-line chemotherapy on overall survival (OS) and postrecurrence survival (PRS) of patients with recurrent ovarian cancer, when stratifying the histologic type.
METHODS
Five hundred and seventy-four patients with recurrent ovarian cancer with sufficient clinical information, including front-line chemotherapy, were analyzed. The pathologic slides were evaluated by central pathologic review. The patients were divided into two groups: group A (n=261), who underwent taxane plus platinum, and group B (n=313), who underwent conventional platinum-based chemotherapy without taxanes.
RESULTS
The median age was 54 years (range, 14 to 89 years). Group A had significantly better median OS (45.0 months vs. 30.3 months, p<0.001) and PRS (23.0 months vs. 13.0 months, p<0.001) compared to group B. The OS and PRS were similar between the groups in patients with clear cell or mucinous histology. In contrast, among patients with non-clear cell, non-mucinous histologies, the OS and PRS of group A were significantly better than those of group B (OS, p<0.001; PRS, p<0.001). Multivariable analyses revealed that, among patients with non-clear cell, non-mucinous histologies, chemotherapy including taxane and platinum was an independent predictor of favorable survival outcomes. Conversely, in patients with clear cell or mucinous histology, taxane-including platinum-based combination chemotherapy did not improve the OS and PRS compared to a conventional platinum-based regimen which did not include taxanes.
CONCLUSION
Since the emergence of taxane plus platinum, the prognosis of patients with recurrent ovarian cancer has improved. However, we here demonstrate that this improvement is limited to patients with non-clear cell, non-mucinous histologies.

Keyword

Chemotherapy; Histologic type; Overall survival; Postrecurrence survival; Recurrent ovarian cancer

MeSH Terms

Drug Therapy
Drug Therapy, Combination
Humans
Mucins
Ovarian Neoplasms*
Platinum*
Prognosis
Taxoids
Mucins
Platinum
Taxoids

Figure

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  Fig. 1 Kaplan-Meier estimated overall survival of all 574 patients with recurrent ovarian cancer according to the type of first-line chemotherapy. Group A, taxane plus platinum; Group B, conventional platinum-based.

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  Fig. 2 Kaplan-Meier estimated postrecurrence survival of all 574 patients with recurrent ovarian cancer according to the type of first-line chemotherapy. Group A, taxane plus platinum; Group B, conventional platinum-based.

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  Fig. 3 Kaplan-Meier estimated overall survival (A) and postrecurrence survival (B) of the patients with clear cell or mucinous histology according to the type of first-line chemotherapy. Group A, taxane plus platinum; Group B, conventional platinum-based.

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  Fig. 4 Kaplan-Meier estimated overall survival (A) and postrecurrence survival (B) of patients with serous, endometrioid, and other histologies according to the type of first-line chemotherapy. Group A, taxane plus platinum; Group B, conventional platinum-based.

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