Effect of adjuvant paclitaxel and carboplatin for advanced stage epithelial ovarian cancer: A population-based cohort study of all patients in western Sweden with long-term follow-up

Objective. To evaluate long-term survival and prognostic factors for all epithelial ovarian cancer (EOC) patients after adjuvant treatment with paclitaxel and carboplatin. Design. Prospectively collected data from a population-based cohort. Setting. Western Sweden Health Care Region. Population. All women diagnosed with EOC between 1998 and 2005. Methods. Data related to age, stage, surgery, histopathology, grade, ploidy status, CA-125, follow-up, recurrence and death of EOC patients (n=976) were prospectively collected in a quality register. No patient was lost to follow-up and the median follow-up was 68 months (range: 27-110). Main outcome measures. Relative survival at 5 and 8 years for all and for those treated with chemotherapy; median progression-free survival (PFS) for stage IIB-IV patients treated with paclitaxel and carboplatin. Results. Relative 5- and 8-year survival rates in the subgroup of patients treated with chemotherapy after surgery (n=853) were 50.4% (95% CI: 46.4-54.3) and 40.5% (95% CI: 35.4-45.6), respectively. The median relative survival time of the entire group of patients was 60 months (95% CI: 52-73). The median PFS for the patients in stage IIB-IV treated with paclitaxel and carboplatin was 18 months (95% CI: 17-20). Well-established prognostic factors of age, stage, residual tumor and post-operative CA-125 were of prognostic significance. Conclusion. Post-surgical adjuvant chemotherapy of paclitaxel and carboplatin for advanced stages of EOC does not seem to increase the relative 5-year survival rate or the median PFS compared to results of earlier studies of a similar patient cohort from the same geographical area.