Reducing uncertainty: Predictors of stopping chemotherapy early and shortened survival time in platinum resistant/refractory ovarian cancer—The GCIG symptombenefit study

Felicia T. Roncolato, Florence Joly, Rachel O’Connell, Anne Lanceley, Felix Hilpert, Luke Buizen, Aikou Okamoto, Eriko Aotani, Sandro Pignata, Paul Donnellan, Amit Oza, Elisabeth Avall-Lundqvist, Jonathan S. Berek, Florian Heitz, Amanda Feeney, Dominique Berton-Rigaud, Martin R. Stockler, Madeleine King, Michael Friedlander, The GCIG Symptom Benefit Group

Research output: Contribution to journalArticlepeer-review

Abstract

Background. Clinicians and patients often overestimate the benefits of chemotherapy, and overall survival (OS), in platinum resistant/refractory ovarian cancer (PRROC). This study sought to determine aspects of health-related quality of life and clinicopathological characteristics before starting chemotherapy that were associated with stopping chemotherapy early, shortened survival, and death within 30 days of chemotherapy. Materials and Methods. This study enrolled women with PRROC before starting palliative chemotherapy. Health-related quality of life was measured with EORTC QLQ-C30/QLQ-OV28. Chemotherapy stopped within 8 weeks of starting was defined as stopping early. Logistic regression was used to assess univariable and multivariable associations with stopping chemotherapy early and death within 30 days of chemotherapy; Cox proportional hazards regression was used to assess associations with progression-free and OS. Results. Low baseline global health status (GHS), role function (RF), physical function (PF), and high abdominal/gastrointestinal symptom (AGIS) were associated with stopping chemotherapy early (all p<.007); low PF and RF remained significant after adjusting for clinicopathological factors (both p <.0401). Most who stopped chemotherapy early had Eastern Cooperative Oncology Group Performance Score 0-1 at baseline (79%); PF, RF, and GHS remained independently significant predictors of stopping chemotherapy early in this subgroup. Death within 30 days of chemotherapy occurred in 14%. LowGHS, RF, and PF remained significantly associated with death within 30 days of chemotherapy after adjusting for clinicopathological factors (all p<.012). Conclusion.Women with low GHS, RF, or PF before starting chemotherapy were more likely to stop chemotherapy early, with short OS. Selfratings of GHS, RF, and PF could improve patient-clinician communication regarding prognosis and help decision-making in women considering chemotherapy for PRROC.

Original languageEnglish
Pages (from-to)1117-1124
Number of pages8
JournalOncologist
Volume22
Issue number9
DOIs
Publication statusPublished - Sep 1 2017

Keywords

  • Patient-reported outcomes
  • Platinum-resistant ovarian cancer
  • Prognosis
  • Quality of life

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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