Feng 2016.
| Study characteristics | ||
| Methods | Retrospective study | |
| Participants | 625 women who underwent primary staging or debulking surgery for high‐grade serous ovarian cancer (HGSC) Age at diagnosis, median (range), years: 56 (30 to 84) FIGO stage: early (I,II) ‐ 58 (9.3%); advanced (III, IV) ‐ 567 (90.7%) Performance status: 0 to 379 (60.6%); 1 to 202 (32.3%); 2 to 44 (7.0%) 132 (21.1%) underwent bowel resection; 91 (14.6%) underwent upper abdominal surgery; 104 (16.6%) underwent lymphadenectomy CA‐125: < 500 U/mL ‐ 144 (23.6%); ≥ 500 U/mL ‐ 465 (76.5%) Ascites: no ‐ 75 (12%); < 500 mL ‐ 104 (16.7%); ≥ 500 mL ‐ 445 (71.3%) China |
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| Residual disease details | Speciality of surgeon not reported After primary cytoreduction, all women received platinum‐based intravenous chemotherapy Chemotherapy regimen:
Majority (441, 70.6%) of women had completed 6 to 8 cycles at intervals of 3 weeks R0 was defined as NMRD after surgery and was noted as follows:
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| Outcomes | PFS was defined as the time interval from the date of primary surgery to the date of disease progression or recurrence Median PFS was 18 months; 2‐year PFS was 38.4%; 5‐year PFS was 21.4% OS was defined as the time interval from the date of the primary surgery to the date of death or last follow‐up 2‐year OS was 82.5%; 5‐year OS was 51.4% At the time of analysis, 355 (56.8%) women were still alive |
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| Risk of bias (QUIPS) | 1. Study participation (a‐f): low risk Adequate number of participants and description of target population. Baseline characteristics, eligibility criteria, sampling frame and period/place study took place presented clearly. 2. Study attrition (a‐e): unclear risk Unclear if patients with incomplete follow‐up were excluded before arriving at the stated sample size. Insufficient information to permit judgement. 3. Prognostic factor measurement (a‐f): low risk Valid and reliable measurement of RD Outcome level assessment: Outcome: overall survival 4. Outcome measurement (a‐c): low risk Valid and reliable measurement of OS. OS was defined as the time interval from the date of the primary surgery to the date of death or last follow‐up 5. Adjustment for other prognostic factors (a‐g): unclear risk Multivariate models for OS adjusted for age, FIGO stage and time to chemotherapy 6. Statistical analysis and reporting (a‐d): high risk No conceptual framework; unclear of variable selection strategy into multivariate model. Unclear on reasoning behind inclusion of other prognostic factors in Cox models. Outcome: progression‐free survival 4. Outcome measurement (a‐c): low risk Valid and reliable measurement of PFS; PFS was defined as the time interval from the date of primary surgery to the date of disease progression or recurrence 5. Adjustment for other prognostic factors (a‐g): unclear risk Multivariate models for PFS adjusted for age, FIGO stage and time to chemotherapy. 6. Statistical analysis and reporting (a‐d): high risk No conceptual framework; unclear of variable selection strategy into multivariate model. Unclear on reasoning behind inclusion of other prognostic factors in Cox models. |
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| Notes | The median (range) follow‐up time was 29 (3 to 100) months The median (range) of time to chemotherapy (TTC) was 15 (4 to 62) days. TTC was longer for women who underwent bowel resection (P < 0.001). There were no differences in PFS and OS between women initiating chemotherapy before and after 15 days (P = 0.604 and 0.826 respectively) or among 4 groups categorised by quartile values (< 10 days, 10 to 14 days, 15 to 20 days, or ≥ 21 days after surgery) (P = 0.471 and 0.516, respectively). The time interval between surgery and chemotherapy seemed to have no prognostic impact on women with HGSC within 6 weeks. Length of hospital stay not reported |
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