Low-grade serous carcinoma (LGSC): A Canadian multicenter review of practice patterns and patient outcomes Conference Paper uri icon

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abstract

  • OBJECTIVE: Patients with advanced low-grade serous carcinoma (LGSC) have poor long-term survival rates. As a rare histotype, there are uncertainties regarding the use of current therapies. Thus, we studied practice patterns and treatment outcomes as part of a national initiative to better understand and improve the care of women with advanced LGSC. METHODS: This retrospective cohort study was conducted in 5 Canadian referral institutions from 2000 to 2016. Data collection and pathology reporting were standardized. Outcome measures included overall survival (OS), progression-free survival (PFS), progression-free intervals (PFI), and time to next treatment (TTNT). Cox regression analysis was used to evaluate the effects of clinical and pathologic factors on outcomes and prognosis. RESULTS: There were 134 patients (stage II-IV) with a median follow-up of 32.4 months (range 1.6-228). Four primary treatments were compared across institutions: 1) surgery followed by chemotherapy (56%), 2) neoadjuvant chemotherapy (NACT) followed by surgery (27%), 3) surgery alone (9%), and 4) surgery followed by anti-hormone therapy (4%). Primary platinum/paclitaxel chemotherapy was used in 81%. Patients treated with NACT had worse PFS. Multivariable Cox regression analysis identified lesser residual disease, younger age, and primary peritoneal origin as variables significantly associated with better OS/PFS (p < 0.03). One institution had significantly better PFS than the others (p = 0.025), but this finding could be related to a higher frequency of primary peritoneal LGSC. PFI and TTNT intervals in patients with relapsed disease were not significantly different after the first relapse irrespective of treatment type. CONCLUSIONS: There are notable differences in practice patterns across Canada. This underscores the need for ongoing strategies to measure, evaluate and achieve optimal patient outcomes for women with advanced LGSC.

authors

  • Scott, Stephanie A
  • Llaurado Fernandez, Marta
  • Kim, Hannah
  • Elit, Laurie
  • Nourmoussavi, Melica
  • Glaze, Sarah
  • Roberts, Lesley
  • Offman, Saul L
  • Rahimi, Kurosh
  • Lytwyn, Alice
  • Sur, Monalisa
  • Gilks, C Blake
  • Matheson, Kara
  • Köbel, Martin
  • Dawson, Amy
  • Tinker, Anna V
  • Kwon, Janice S
  • Hoskins, Paul
  • Santos, Jennifer L
  • Cheung, Andrea
  • Provencher, Diane
  • Carey, Mark S

publication date

  • April 2020

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