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Self-reported quality of life among patients who have undergone outpatient intraperitoneal chemotherapy for ovarian cancer
Abstracts / Gynecologic Oncology 141 (2016) 2–208
OF
doi:10.1016/j.ygyno.2016.04.314
283 – Poster The survival rate of abdominal radical trachelectomy versus abdominal radical hysterectomy for stage IB1 cervical cancer ≥2 cm X. Wu, X. Li, J. Li. Fudan University Shanghai Cancer Center, Shanghai, China Objectives: To compare the survival rates of abdominal radical trachelectomy (ART) with those of abdominal radical hysterectomy (ARH) for stage IB1 cervical cancer. Our objective was to know whether it was safe to perform ART for stage IB1 cervical cancers of 2 cm or larger. Methods: Patients with stage IB1 cervical cancer who underwent ART and lymph node dissection between November 2006 and December 2014 had been compared to patients treated with ARH by the same surgeon at our institution in the same period. The control group consisted of patients with stage IB1 diseases who met the inclusion criteria of a fertility-sparing surgery. Results: Of the 107 and 141 patients who underwent ART and ARH, respectively, 61 and 82 patients had a tumor of 2 cm or larger (P = NS). With a median follow-up of 30 and 49 months, 2 patients treated with ART and 3 patients treated with ARH had recurrences: the 5-year recurrence-free survival (RFS) rate was 97.8% and 97.0%, respectively (P = NS). Only 3 patients died in the ARH group. The 5year overall survival (OS) was 100% for the ART group and 96.9% for the ARH group (P = NS). Considering tumors measuring 2 to 4 cm, the 5year RFS and the 5-year OS were 96.5% and 100%, respectively, for the ART group, and 94.8% and 94.8% for the ARH group. The difference of 5year RFS and 5-year OS between the 2 groups did not reach statistical significance. Conclusions: ART appears to have equal or better survival rates to ARH and can be performed safely in stage IB1 cervical cancers 2 cm or larger in size.
DP
doi:10.1016/j.ygyno.2016.04.313
Fig. 1. Patients’ Subjective Opinions Regarding IP Chemotherapy.
RO
Methods: We enrolled patients with advanced epithelial ovarian cancer (FIGO stage III and IV) who were treated at the Samsung Medical Center from January 1, 2001, to December 31, 2010. We excluded patients who received neoadjuvant chemotherapy. Results: A total of 507 patients (stage III: 448; stage IV: 59) were enrolled, and the median ISC was 9 days with a range of 4 to 84 days. We divided the patients into 3 groups: (1) no gross residual group (n = 109, 21.5%), (2) optimal group (n = 206, 40.6%), and (3) suboptimal group (n = 192, 37.9%); delayed ISC is associated with increased HRs of overall survival only in the optimal group. Subsequent analyses were performed in the optimal group, and we found that ISC as a continuous variable (HR 1.016, 95% CI 1.005– 1.031, P = .007), history of consultation to the department of general surgery (HR 2.744, 95% CI 1.345–5.599, P = .006), and platinum resistance (HR 7.175, 95% CI 4.112–12.52, P = .007) were significantly associated with poor overall survival. On multivariate analysis, ISC continued to be a significant poor prognostic factor (HR 1.018, 95% CI 1.003–1.033, P = .022). Conclusions: Based on the data collected, delayed adjuvant chemotherapy subsequent to surgery most likely would result in a negative impact on overall survival in advanced epithelial ovarian cancer patients who had optimal cytoreduction.
117
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282 – Poster Self-reported quality of life among patients who have undergone outpatient intraperitoneal chemotherapy for ovarian cancer K. Gotimer, C. Bondoc, E. Chalas, J.A. Villella. Winthrop University Hospital, Mineola, NY, USA
UN
CO
RR
EC
Objectives: To assess the impact of outpatient intraperitoneal (IP) chemotherapy on quality of life (QOL). Methods: Cross-sectional study of patients with optimally cytoreduced stage III and IV ovarian cancer who received IP chemotherapy between 2006 and 2011 at a single institution. A selfadministered, anonymous survey based on a QOL instrument, the FACT-O, assessed 4 domains: physical health (PH), mental health (MH), social health (SH), and patients' subjective sense of worth (WO) of IP chemotherapy. Results: Seventy-one participants were mailed surveys, of whom 52 (73.2%) returned the survey, 4 were excluded (incomplete), and 48 (67.6%) were included in the final sample. Mean age was 62.4 ± 10.3 years. Mean time from completion of chemotherapy was 30.8 months (range, 3–58 years). In the PH domain, 50.0% of patients reported that fatigue severely affected their QOL. Other aspects were pain (39.6%), gastrointestinal problems (37.5%), “chemotherapy brain” (29.2%), and alopecia (25%). In the MH domain, 25% of patients reported that therapy put significant stress on their life, 20.8% experienced anxiety, and 14.6% depression. In the SH domain, 27.5% reported that IP chemotherapy interfered with work. The majority (83.3%) reported that the effectiveness of IP chemotherapy was “worth” the side effects, 95.8% did not regret it, and 87.5% would recommend it to a friend. Eleven patients had recurrent disease at the time of survey completion, of whom 90% indicated IP chemotherapy was worthwhile and would recommend it to a friend, and none regretted the decision to receive this therapy. (See Fig. 1.) Conclusions: IP chemotherapy has been shown to improve overall and progression-free survival and yet is not universally prescribed. It is known to have more side effects than intravenous chemotherapy. Further understanding of impact on QOL may help guide practice and patient counseling, thus improving adherence. The present study suggests that while these side effects affect QOL, patients feel that the therapy is worthwhile and do not regret treatment.
doi:10.1016/j.ygyno.2016.04.315
284 – Poster Appendectomy for mucinous ovarian tumors: Is it really necessary? D.E. Vlachosa, N. Thomakosb, M. Sotiropouloub, D. Haidopoulosb, M. Davidovic-Grigorakia, M. Liontosb, D.C. Papatheodoroua, A. Bamiasb, A. Rodolakisb, G. Vlachosb. aUniversity of Athens School of Medicine, Alexandra Hospital, Athens, Greece, bAlexandra Hospital, University of Athens, Athens, Greece Objectives: Recent literature suggests that the appendix is usually affected in cases of mucinous ovarian carcinomas and that primary
OF
doi:10.1016/j.ygyno.2016.04.314
283 – Poster The survival rate of abdominal radical trachelectomy versus abdominal radical hysterectomy for stage IB1 cervical cancer ≥2 cm X. Wu, X. Li, J. Li. Fudan University Shanghai Cancer Center, Shanghai, China Objectives: To compare the survival rates of abdominal radical trachelectomy (ART) with those of abdominal radical hysterectomy (ARH) for stage IB1 cervical cancer. Our objective was to know whether it was safe to perform ART for stage IB1 cervical cancers of 2 cm or larger. Methods: Patients with stage IB1 cervical cancer who underwent ART and lymph node dissection between November 2006 and December 2014 had been compared to patients treated with ARH by the same surgeon at our institution in the same period. The control group consisted of patients with stage IB1 diseases who met the inclusion criteria of a fertility-sparing surgery. Results: Of the 107 and 141 patients who underwent ART and ARH, respectively, 61 and 82 patients had a tumor of 2 cm or larger (P = NS). With a median follow-up of 30 and 49 months, 2 patients treated with ART and 3 patients treated with ARH had recurrences: the 5-year recurrence-free survival (RFS) rate was 97.8% and 97.0%, respectively (P = NS). Only 3 patients died in the ARH group. The 5year overall survival (OS) was 100% for the ART group and 96.9% for the ARH group (P = NS). Considering tumors measuring 2 to 4 cm, the 5year RFS and the 5-year OS were 96.5% and 100%, respectively, for the ART group, and 94.8% and 94.8% for the ARH group. The difference of 5year RFS and 5-year OS between the 2 groups did not reach statistical significance. Conclusions: ART appears to have equal or better survival rates to ARH and can be performed safely in stage IB1 cervical cancers 2 cm or larger in size.
DP
doi:10.1016/j.ygyno.2016.04.313
Fig. 1. Patients’ Subjective Opinions Regarding IP Chemotherapy.
RO
Methods: We enrolled patients with advanced epithelial ovarian cancer (FIGO stage III and IV) who were treated at the Samsung Medical Center from January 1, 2001, to December 31, 2010. We excluded patients who received neoadjuvant chemotherapy. Results: A total of 507 patients (stage III: 448; stage IV: 59) were enrolled, and the median ISC was 9 days with a range of 4 to 84 days. We divided the patients into 3 groups: (1) no gross residual group (n = 109, 21.5%), (2) optimal group (n = 206, 40.6%), and (3) suboptimal group (n = 192, 37.9%); delayed ISC is associated with increased HRs of overall survival only in the optimal group. Subsequent analyses were performed in the optimal group, and we found that ISC as a continuous variable (HR 1.016, 95% CI 1.005– 1.031, P = .007), history of consultation to the department of general surgery (HR 2.744, 95% CI 1.345–5.599, P = .006), and platinum resistance (HR 7.175, 95% CI 4.112–12.52, P = .007) were significantly associated with poor overall survival. On multivariate analysis, ISC continued to be a significant poor prognostic factor (HR 1.018, 95% CI 1.003–1.033, P = .022). Conclusions: Based on the data collected, delayed adjuvant chemotherapy subsequent to surgery most likely would result in a negative impact on overall survival in advanced epithelial ovarian cancer patients who had optimal cytoreduction.
117
TE
282 – Poster Self-reported quality of life among patients who have undergone outpatient intraperitoneal chemotherapy for ovarian cancer K. Gotimer, C. Bondoc, E. Chalas, J.A. Villella. Winthrop University Hospital, Mineola, NY, USA
UN
CO
RR
EC
Objectives: To assess the impact of outpatient intraperitoneal (IP) chemotherapy on quality of life (QOL). Methods: Cross-sectional study of patients with optimally cytoreduced stage III and IV ovarian cancer who received IP chemotherapy between 2006 and 2011 at a single institution. A selfadministered, anonymous survey based on a QOL instrument, the FACT-O, assessed 4 domains: physical health (PH), mental health (MH), social health (SH), and patients' subjective sense of worth (WO) of IP chemotherapy. Results: Seventy-one participants were mailed surveys, of whom 52 (73.2%) returned the survey, 4 were excluded (incomplete), and 48 (67.6%) were included in the final sample. Mean age was 62.4 ± 10.3 years. Mean time from completion of chemotherapy was 30.8 months (range, 3–58 years). In the PH domain, 50.0% of patients reported that fatigue severely affected their QOL. Other aspects were pain (39.6%), gastrointestinal problems (37.5%), “chemotherapy brain” (29.2%), and alopecia (25%). In the MH domain, 25% of patients reported that therapy put significant stress on their life, 20.8% experienced anxiety, and 14.6% depression. In the SH domain, 27.5% reported that IP chemotherapy interfered with work. The majority (83.3%) reported that the effectiveness of IP chemotherapy was “worth” the side effects, 95.8% did not regret it, and 87.5% would recommend it to a friend. Eleven patients had recurrent disease at the time of survey completion, of whom 90% indicated IP chemotherapy was worthwhile and would recommend it to a friend, and none regretted the decision to receive this therapy. (See Fig. 1.) Conclusions: IP chemotherapy has been shown to improve overall and progression-free survival and yet is not universally prescribed. It is known to have more side effects than intravenous chemotherapy. Further understanding of impact on QOL may help guide practice and patient counseling, thus improving adherence. The present study suggests that while these side effects affect QOL, patients feel that the therapy is worthwhile and do not regret treatment.
doi:10.1016/j.ygyno.2016.04.315
284 – Poster Appendectomy for mucinous ovarian tumors: Is it really necessary? D.E. Vlachosa, N. Thomakosb, M. Sotiropouloub, D. Haidopoulosb, M. Davidovic-Grigorakia, M. Liontosb, D.C. Papatheodoroua, A. Bamiasb, A. Rodolakisb, G. Vlachosb. aUniversity of Athens School of Medicine, Alexandra Hospital, Athens, Greece, bAlexandra Hospital, University of Athens, Athens, Greece Objectives: Recent literature suggests that the appendix is usually affected in cases of mucinous ovarian carcinomas and that primary