Tumor Growth Rate Estimates Are Independently Predictive of Therapy Response and Survival in Recurrent High-Grade Serous Ovarian Cancer Patients
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
3. Results
3.1. Description and Comparison between the Exploratory and Validation Cohorts
3.2. Growth Rate Estimate as a Predictor of Therapy Response
3.3. Growth Rate Estimate Is Independently Predictive of Overall Survival
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Parameter | Exploratory Cohort | Validation Cohort |
---|---|---|
Number of patients | 155 | 146 |
Age at surgery (years) | 58.0 (49.0–66.0) | 57.0 (48.8–64.3) |
FIGO stage (2014) | ||
II | 6 (3.9%) | 5 (3.4%) |
III | 132 (85.2%) | 123 (84.3%) |
IV | 17 (11.0%) | 18 (12.3%) |
Residual tumor after primary surgery | ||
Yes | 48 (30.8%) | 50 (34.2%) |
No | 107 (68.6%) | 96 (65.8%) |
CA-125 at primary surgery (kU/L) | 558.0 (221.5–1491.3) | 504 (140.5–1301.0) |
Time to nadir (days) | 103.5 (73.3–161.3) | not available |
Log growth rate estimate at 1st recurrence | −3.5 (−4.3–−3.1) | −3.4 (−4.1–−3.0) |
Log decay rate estimate at 1st recurrence | −1.3 (−1.5–−1.1) | −1.0 (−1.1–−0.9) |
Status at last follow-up | ||
Alive | 38 (24.5%) | 42 (28.8%) |
Progression | 4 (2.6%) | not available |
Intercurrent death | 26 (16.8%) | 18 (12.3%) |
Cancer-related death | 87 (56.1%) | 78 (53.4%) |
Duration of follow-up (months) | 53.0 (27.0–85.0) | 46.0 (28.8–71.5) |
TFST (months) | 15.0 (8.0–25.5) | 14.5 (7.0–23.0) |
Available | 117 (75.5%) | 113 (77.4) |
Not available | 38 (24.5%) | 33 (22.6) |
TSST (months) | 7.0 (2.5–11.5) | 8.0 (3.0–13.0) |
Available | 73 (47.1%) | 68 (46.6%) |
Not available | 82 (52.9%) | 78 (53.4%) |
TFI 2nd to 3rd recurrence (months) | 5.0 (1.0–10.0) | 4.0 (1.0–9.0) |
Available | 42 (27.1%) | 45 (30.8%) |
Not available | 113 (72.9%) | 101 (69.2%) |
2a. Parameters Exploratory Cohort | Response to Second-Line Chemotherapy | |||
Univariate Analysis | Multivariable Analysis | |||
p-Value | OR (95% CI) | p-Value | OR (95% CI) | |
Log growth rate constant >−3.32 | <0.001 | 2.57 (1.60–4.12) | 0.003 | 5.19 (1.73–15.58) |
Therapy-free interval >6 months | 0.005 | 1.73 (1.29–2.31) | 0.453 | 1.95 (0.34–11.17) |
Age at time of therapy >60 years | 0.03 | 1.35 (1.04–1.74) | 0.006 | 5.32 (1.63–17.38) |
Platinum-based therapy yes/no | <0.001 | 5.39 (2.92–9.95) | <0.001 | 16.06 (4.48–53.29) |
FIGO stage (2014) > FIGO IIIc | 0.055 | 1.69 (0.86–3.34) | - | - |
2b. Parameters Validation Cohort | Response to Second-Line Chemotherapy | |||
Univariate Analysis | Multivariable Analysis | |||
p-Value | OR (95% CI) | p-Value | OR (95% CI) | |
Log growth rate constant >−3.32 | 0.008 | 1.60 (1.10–2.33) | 0.03 | 3.67 (1.13–11.86) |
Therapy-free interval >6 months | 0.025 | 1.81 (0.95–3.47) | 0.661 | 1.48 (0.26–8.46) |
Age at time of therapy >60 years | 0.03 | 7.58 (1.11–51.66) | 0.056 | 10.15 (0.94–109.25) |
Platinum-based therapy yes/no | <0.001 | 2.65 (1.51–4.65) | 0.016 | 5.79 (1.40–24.05) |
FIGO stage (2014) > FIGO IIIc | 0.048 | 1.68 (0.89–3.18) | - | - |
3a. Parameters Exploratory Cohort | Prognostic Value for Second-Line Chemotherapy | |||
Univariate Analysis | Multivariable Analysis | |||
p-Value | HR (95% CI) | p-Value | ||
Log growth rate constant > −3.32 | 0.006 | 2.13 (1.37–3.32) | 0.005 | 1.92 (1.22–3.03) |
Therapy-free interval > 6 months | 0.014 | 1.93 (0.96–3.87) | 0.524 | 1.29 (0.59–2.82) |
Age at time of therapy > 60 years | 0.005 | 1.82 (1.17–2.85) | - | - |
Platinum-based therapy yes/no | <0.001 | 2.66 (1.69–4.17) | 0.001 | 2.34 (1.41–3.87) |
Bevacizumab received yes/no | 0.934 | 1.02 (0.60–1.76) | 0.504 | 1.25 (0.65–2.38) |
No primary surgery residual tumor (R0) | 0.045 | 1.46 (0.93–2.29) | - | - |
FIGO stage (2014) > FIGO IIIc | 0.595 | 1.32 (0.66–2.65) | - | - |
3b. Parameters Validation Cohort | Prognostic Value for Second-Line Chemotherapy | |||
Univariate Analysis | Multivariable Analysis | |||
p-Value | HR (95% CI) | p-Value | ||
Log growth rate constant >−3.32 | <0.001 | 3.31 (1.74–6.29) | 0.002 | 2.90 (1.50–5.59) |
Therapy-free interval >6 months | <0.001 | 1.44 (0.73–2.81) | 0.642 | 1.13 (0.83–1.79) |
Age at time of therapy >60 years | <0.001 | 1.58 (1.01–2.48) | - | - |
Platinum-based therapy yes/no | 0.001 | 2.10 (1.30–3.39) | 0.015 | 2.23 (1.17–4.23) |
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Bartl, T.; Karacs, J.; Kreuzinger, C.; Pfaffinger, S.; Kendler, J.; Ciocsirescu, C.; Wolf, A.; Reinthaller, A.; Meyer, E.; Brandstetter, M.; et al. Tumor Growth Rate Estimates Are Independently Predictive of Therapy Response and Survival in Recurrent High-Grade Serous Ovarian Cancer Patients. Cancers 2021, 13, 1076. https://doi.org/10.3390/cancers13051076
Bartl T, Karacs J, Kreuzinger C, Pfaffinger S, Kendler J, Ciocsirescu C, Wolf A, Reinthaller A, Meyer E, Brandstetter M, et al. Tumor Growth Rate Estimates Are Independently Predictive of Therapy Response and Survival in Recurrent High-Grade Serous Ovarian Cancer Patients. Cancers. 2021; 13(5):1076. https://doi.org/10.3390/cancers13051076
Chicago/Turabian StyleBartl, Thomas, Jasmine Karacs, Caroline Kreuzinger, Stephanie Pfaffinger, Jonatan Kendler, Cristina Ciocsirescu, Andrea Wolf, Alexander Reinthaller, Elias Meyer, Maximilian Brandstetter, and et al. 2021. "Tumor Growth Rate Estimates Are Independently Predictive of Therapy Response and Survival in Recurrent High-Grade Serous Ovarian Cancer Patients" Cancers 13, no. 5: 1076. https://doi.org/10.3390/cancers13051076