Utilization of intraperitoneal chemotherapy for optimally cytoreduced advanced stage epithelial ovarian cancer: A 10-year single institution experience with a racially diverse urban population

Eirwen M. Miller, Joan Tymon-Rosario, Xianhong Xie, Xiaonan Xue, Gregory M. Gressel, Devin T. Miller, Dennis YS Kuo, Nicole S. Nevadunsky

Research output: Contribution to journalArticle

Abstract

Objectives The goal of our study was to define utilization and clinical results of intraperitoneal (IV/IP) compared to intravenous (IV) chemotherapy in a racially and ethnically diverse population with optimally debulked advanced stage epithelial ovarian cancer. Methods After IRB approval, all patients diagnosed with epithelial ovarian cancer that underwent primary cytoreductive surgery at our institution from 2005 to 2016 were identified. Death was verified by the National Social Security Death Index. Patients who received at least one IV/IP cycle were analyzed in the IV/IP cohort. Kaplan-Meier and Cox proportional hazards models were performed. Results 96 patients with advanced stage optimally cytoreduced epithelial ovarian cancer (median follow up 33 months) were identified. 51% and 49% of patients received IV/IP and IV chemotherapy, respectively. 27%, 22%, and 39% of patients were of white, black, and other race. Compared with IV chemotherapy only, IV/IP chemotherapy was associated with longer OS (log rank < 0.002) and IV/IP chemotherapy versus IV chemotherapy alone was associated with a lower risk of death (HR = 0.31, 95% CI 0.16–0.62, P < 0.001). The median overall survival for the IV/IP and IV groups was 76 months (95% CI 62 - not estimated) and 38 months (95% CI 30–55), respectively. There was a trend toward higher risk of death for patients who completed fewer than 6 cycles of IV/IP chemotherapy compared to women who completed 6 IV/IP cycles (HR = 3.2, 95% CI 0.98–9.27 (P = 0.05). No differences in patient or tumor characteristics were identified between these two groups of patients. Conclusions In our racially diverse urban patients, 50% of patients received IV/IP chemotherapy and it was associated with improved overall survival compared to IV chemotherapy alone. Further investigation is needed to identify barriers to use of IV/IP chemotherapy.

Original languageEnglish (US)
Pages (from-to)36-40
Number of pages5
JournalGynecologic Oncology
Volume147
Issue number1
DOIs
StatePublished - Oct 2017
Externally publishedYes

Fingerprint

Urban Population
antineoplaston A10
Drug Therapy
Ovarian epithelial cancer
Security Measures
Survival
Social Security
Research Ethics Committees
Proportional Hazards Models

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

Cite this

Utilization of intraperitoneal chemotherapy for optimally cytoreduced advanced stage epithelial ovarian cancer : A 10-year single institution experience with a racially diverse urban population. / Miller, Eirwen M.; Tymon-Rosario, Joan; Xie, Xianhong; Xue, Xiaonan; Gressel, Gregory M.; Miller, Devin T.; Kuo, Dennis YS; Nevadunsky, Nicole S.

In: Gynecologic Oncology, Vol. 147, No. 1, 10.2017, p. 36-40.

Research output: Contribution to journalArticle

@article{94464cd4078740b6b52d70be105b8457,
title = "Utilization of intraperitoneal chemotherapy for optimally cytoreduced advanced stage epithelial ovarian cancer: A 10-year single institution experience with a racially diverse urban population",
abstract = "Objectives The goal of our study was to define utilization and clinical results of intraperitoneal (IV/IP) compared to intravenous (IV) chemotherapy in a racially and ethnically diverse population with optimally debulked advanced stage epithelial ovarian cancer. Methods After IRB approval, all patients diagnosed with epithelial ovarian cancer that underwent primary cytoreductive surgery at our institution from 2005 to 2016 were identified. Death was verified by the National Social Security Death Index. Patients who received at least one IV/IP cycle were analyzed in the IV/IP cohort. Kaplan-Meier and Cox proportional hazards models were performed. Results 96 patients with advanced stage optimally cytoreduced epithelial ovarian cancer (median follow up 33 months) were identified. 51{\%} and 49{\%} of patients received IV/IP and IV chemotherapy, respectively. 27{\%}, 22{\%}, and 39{\%} of patients were of white, black, and other race. Compared with IV chemotherapy only, IV/IP chemotherapy was associated with longer OS (log rank < 0.002) and IV/IP chemotherapy versus IV chemotherapy alone was associated with a lower risk of death (HR = 0.31, 95{\%} CI 0.16–0.62, P < 0.001). The median overall survival for the IV/IP and IV groups was 76 months (95{\%} CI 62 - not estimated) and 38 months (95{\%} CI 30–55), respectively. There was a trend toward higher risk of death for patients who completed fewer than 6 cycles of IV/IP chemotherapy compared to women who completed 6 IV/IP cycles (HR = 3.2, 95{\%} CI 0.98–9.27 (P = 0.05). No differences in patient or tumor characteristics were identified between these two groups of patients. Conclusions In our racially diverse urban patients, 50{\%} of patients received IV/IP chemotherapy and it was associated with improved overall survival compared to IV chemotherapy alone. Further investigation is needed to identify barriers to use of IV/IP chemotherapy.",
author = "Miller, {Eirwen M.} and Joan Tymon-Rosario and Xianhong Xie and Xiaonan Xue and Gressel, {Gregory M.} and Miller, {Devin T.} and Kuo, {Dennis YS} and Nevadunsky, {Nicole S.}",
year = "2017",
month = "10",
doi = "10.1016/j.ygyno.2017.07.129",
language = "English (US)",
volume = "147",
pages = "36--40",
journal = "Gynecologic Oncology",
issn = "0090-8258",
publisher = "Academic Press Inc.",
number = "1",

}

TY - JOUR

T1 - Utilization of intraperitoneal chemotherapy for optimally cytoreduced advanced stage epithelial ovarian cancer

T2 - A 10-year single institution experience with a racially diverse urban population

AU - Miller, Eirwen M.

AU - Tymon-Rosario, Joan

AU - Xie, Xianhong

AU - Xue, Xiaonan

AU - Gressel, Gregory M.

AU - Miller, Devin T.

AU - Kuo, Dennis YS

AU - Nevadunsky, Nicole S.

PY - 2017/10

Y1 - 2017/10

N2 - Objectives The goal of our study was to define utilization and clinical results of intraperitoneal (IV/IP) compared to intravenous (IV) chemotherapy in a racially and ethnically diverse population with optimally debulked advanced stage epithelial ovarian cancer. Methods After IRB approval, all patients diagnosed with epithelial ovarian cancer that underwent primary cytoreductive surgery at our institution from 2005 to 2016 were identified. Death was verified by the National Social Security Death Index. Patients who received at least one IV/IP cycle were analyzed in the IV/IP cohort. Kaplan-Meier and Cox proportional hazards models were performed. Results 96 patients with advanced stage optimally cytoreduced epithelial ovarian cancer (median follow up 33 months) were identified. 51% and 49% of patients received IV/IP and IV chemotherapy, respectively. 27%, 22%, and 39% of patients were of white, black, and other race. Compared with IV chemotherapy only, IV/IP chemotherapy was associated with longer OS (log rank < 0.002) and IV/IP chemotherapy versus IV chemotherapy alone was associated with a lower risk of death (HR = 0.31, 95% CI 0.16–0.62, P < 0.001). The median overall survival for the IV/IP and IV groups was 76 months (95% CI 62 - not estimated) and 38 months (95% CI 30–55), respectively. There was a trend toward higher risk of death for patients who completed fewer than 6 cycles of IV/IP chemotherapy compared to women who completed 6 IV/IP cycles (HR = 3.2, 95% CI 0.98–9.27 (P = 0.05). No differences in patient or tumor characteristics were identified between these two groups of patients. Conclusions In our racially diverse urban patients, 50% of patients received IV/IP chemotherapy and it was associated with improved overall survival compared to IV chemotherapy alone. Further investigation is needed to identify barriers to use of IV/IP chemotherapy.

AB - Objectives The goal of our study was to define utilization and clinical results of intraperitoneal (IV/IP) compared to intravenous (IV) chemotherapy in a racially and ethnically diverse population with optimally debulked advanced stage epithelial ovarian cancer. Methods After IRB approval, all patients diagnosed with epithelial ovarian cancer that underwent primary cytoreductive surgery at our institution from 2005 to 2016 were identified. Death was verified by the National Social Security Death Index. Patients who received at least one IV/IP cycle were analyzed in the IV/IP cohort. Kaplan-Meier and Cox proportional hazards models were performed. Results 96 patients with advanced stage optimally cytoreduced epithelial ovarian cancer (median follow up 33 months) were identified. 51% and 49% of patients received IV/IP and IV chemotherapy, respectively. 27%, 22%, and 39% of patients were of white, black, and other race. Compared with IV chemotherapy only, IV/IP chemotherapy was associated with longer OS (log rank < 0.002) and IV/IP chemotherapy versus IV chemotherapy alone was associated with a lower risk of death (HR = 0.31, 95% CI 0.16–0.62, P < 0.001). The median overall survival for the IV/IP and IV groups was 76 months (95% CI 62 - not estimated) and 38 months (95% CI 30–55), respectively. There was a trend toward higher risk of death for patients who completed fewer than 6 cycles of IV/IP chemotherapy compared to women who completed 6 IV/IP cycles (HR = 3.2, 95% CI 0.98–9.27 (P = 0.05). No differences in patient or tumor characteristics were identified between these two groups of patients. Conclusions In our racially diverse urban patients, 50% of patients received IV/IP chemotherapy and it was associated with improved overall survival compared to IV chemotherapy alone. Further investigation is needed to identify barriers to use of IV/IP chemotherapy.

UR - http://www.scopus.com/inward/record.url?scp=85025458559&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85025458559&partnerID=8YFLogxK

U2 - 10.1016/j.ygyno.2017.07.129

DO - 10.1016/j.ygyno.2017.07.129

M3 - Article

C2 - 28751119

AN - SCOPUS:85025458559

VL - 147

SP - 36

EP - 40

JO - Gynecologic Oncology

JF - Gynecologic Oncology

SN - 0090-8258

IS - 1

ER -