Objectives: To validate and improve an established prognostic index in patients with recurrent ovarian cancer. Methods: A Canadian three-covariate prognostic index (tumour grade at diagnosis, initial performance statu...Objectives: To validate and improve an established prognostic index in patients with recurrent ovarian cancer. Methods: A Canadian three-covariate prognostic index (tumour grade at diagnosis, initial performance status, and time to relapse/-primary progression (TRP)) was validated in a well-defined cohort of comparable Danish patients. Potential parameters to be included in an improved prognostic index were revealed by univariate and multivariate analyses in the Danish validation group. Results: The Canadian index validated in the Danish patient population (n = 189) found a statistical significant difference in survival between the prognostic groups good and intermediate (P < 0.0001),whereas therewas no significant difference in survival between the prognostic groups intermediate and poor (P = 0.51). In order to improve the accuracy of the index, the candidate parameters, treatment free interval (TFI), CA125 level and performance status, at time of relapse/primary progression, were added, whereas the parameters, tumour grade, and initial performance status, from the Canadian index were excluded. As the correlation coefficient between TRP and TFI was very high (r = 0.91), TRP was substituted with TFI in the improved prognostic model. The final model was: 0.8 (performance status) +0.33 log (CA125)-1.31 log (TFI). The improved model was a good predictor of one-year survival (AUC 0.85; logistic regression; P < 0.0001). The median survival (with 95%CI) of the four prognostic groups (A-D) was 50.6 (34.0-not available), 25.0 (22.1-33.6), 11.3 (8.5-12.9), and 5.2 (3.5-6.3) months, respectively. Conclusions: A novel prognostic model (the Copenhagen index) for patientswith recurrent ovarian cancer is presented.展开更多
Objective. Recurrent ovarian carcinoma is considered an incurable dis ease and second-line chemotherapy is administered for extension of survival and palliati on. The impact of continued antineoplastic treatment in pa...Objective. Recurrent ovarian carcinoma is considered an incurable dis ease and second-line chemotherapy is administered for extension of survival and palliati on. The impact of continued antineoplastic treatment in patients with stable dis ease without a demonstrable response is uncertain. The aim of this analysis was to assess the value of a stabilization of the tumor size in second-line chemoth erapy as an indicator of survival. Methods. Retrospective, single-institution s tudy of 487 consecutive patients with primary epithelial ovarian carcinoma. Incl usion criteria: (1) FIGO stage IC-IV epithelial ovarian carcinoma; (2) first-l ine chemotherapy with Paclitaxel and a Platinum-compound; (3) refractory, persi stent, or recurrent disease diagnosed by imaging methods; and (4) intravenous se cond-line chemotherapy with single Topotecan or Paclitaxel-Carboplatin. Univar iate and multivariate analyses of survival with theWorld Health Organization (WH O) tumor response parameter included as a time-dependent variable were performe d. Results. The response rates were (N = 100): complete response (CR) 27%, part ial response (PR) 14%, stable disease (SD) 41%and progressive disease (PD) 18 %. In a multivariate Cox regression analysis of survival, SD was found to be an independent prognostic factor for survival and the death hazard ratio was 0.37 (SD versus PD; 95%CI: 0.16-0.86; P = 0.02). There was no statistically signifi cant difference in survival between patients with PR and SD (P = 0.09). Conclusi on. In secondline chemotherapy of ovarian cancer,patients demonstrating SD have a survival benefit compared to patients with PD measured by theWHO tumor respons e criteria.展开更多
文摘Objectives: To validate and improve an established prognostic index in patients with recurrent ovarian cancer. Methods: A Canadian three-covariate prognostic index (tumour grade at diagnosis, initial performance status, and time to relapse/-primary progression (TRP)) was validated in a well-defined cohort of comparable Danish patients. Potential parameters to be included in an improved prognostic index were revealed by univariate and multivariate analyses in the Danish validation group. Results: The Canadian index validated in the Danish patient population (n = 189) found a statistical significant difference in survival between the prognostic groups good and intermediate (P < 0.0001),whereas therewas no significant difference in survival between the prognostic groups intermediate and poor (P = 0.51). In order to improve the accuracy of the index, the candidate parameters, treatment free interval (TFI), CA125 level and performance status, at time of relapse/primary progression, were added, whereas the parameters, tumour grade, and initial performance status, from the Canadian index were excluded. As the correlation coefficient between TRP and TFI was very high (r = 0.91), TRP was substituted with TFI in the improved prognostic model. The final model was: 0.8 (performance status) +0.33 log (CA125)-1.31 log (TFI). The improved model was a good predictor of one-year survival (AUC 0.85; logistic regression; P < 0.0001). The median survival (with 95%CI) of the four prognostic groups (A-D) was 50.6 (34.0-not available), 25.0 (22.1-33.6), 11.3 (8.5-12.9), and 5.2 (3.5-6.3) months, respectively. Conclusions: A novel prognostic model (the Copenhagen index) for patientswith recurrent ovarian cancer is presented.
文摘Objective. Recurrent ovarian carcinoma is considered an incurable dis ease and second-line chemotherapy is administered for extension of survival and palliati on. The impact of continued antineoplastic treatment in patients with stable dis ease without a demonstrable response is uncertain. The aim of this analysis was to assess the value of a stabilization of the tumor size in second-line chemoth erapy as an indicator of survival. Methods. Retrospective, single-institution s tudy of 487 consecutive patients with primary epithelial ovarian carcinoma. Incl usion criteria: (1) FIGO stage IC-IV epithelial ovarian carcinoma; (2) first-l ine chemotherapy with Paclitaxel and a Platinum-compound; (3) refractory, persi stent, or recurrent disease diagnosed by imaging methods; and (4) intravenous se cond-line chemotherapy with single Topotecan or Paclitaxel-Carboplatin. Univar iate and multivariate analyses of survival with theWorld Health Organization (WH O) tumor response parameter included as a time-dependent variable were performe d. Results. The response rates were (N = 100): complete response (CR) 27%, part ial response (PR) 14%, stable disease (SD) 41%and progressive disease (PD) 18 %. In a multivariate Cox regression analysis of survival, SD was found to be an independent prognostic factor for survival and the death hazard ratio was 0.37 (SD versus PD; 95%CI: 0.16-0.86; P = 0.02). There was no statistically signifi cant difference in survival between patients with PR and SD (P = 0.09). Conclusi on. In secondline chemotherapy of ovarian cancer,patients demonstrating SD have a survival benefit compared to patients with PD measured by theWHO tumor respons e criteria.
