Abstract：
The aim of the study was to investigate if time to start chemotherapy (TTC) after primary debulking surgery (PDS) impacted relative survival (RS) in advanced epithelial ovarian/fallopian tube/primary peritoneal cancer (EOC).
Nationwide population-based study of women with EOC FIGO stages IIIC-IV, registered 2008-2018 in the Swedish Quality Register for Gynecologic Cancer, treated with PDS and chemotherapy. TTC was categorized into; ≤21 days, 22-28 days, 29-35 days, 36-42 days and > 42 days. Relative survival (RS) was estimated using the Pohar-Perme estimate of net survival. Multivariable analyses of excess mortality rate ratios (EMRRs) were estimated by Poisson regression models.
In total, 1694 women were included. The median age was 65.0 years. Older age and no residual disease were more common in TTC >42 days than 0-21 days. The RS at 5-years was 37.9% and did not differ between TTC groups. In the R0 (no residual disease) cohort (n = 806), 2-year RS was higher in TTC ≤21 days (91.6%) and 22-28 days (91.4%) than TTC >42 days (79.1%). TTC >42 days (EMRR 2.33, p = 0.026), FIGO stage IV (EMRR 1.83, p = 0.007) and non-serous histology (EMRR 4.20, p < 0.001) were associated with 2-year worse excess mortality compared to TTC 0-21 days, in the R0 cohort. TTC was associated with 2-year survival in the R0 cohort in FIGO stage IV but not in stage IIIC. TTC was not associated with RS in patients with residual disease.
For the entire cohort, stage IV, non-serous morphology and residual disease, but not TTC, influenced 5-year relative survival. However, longer TTC was associated with a poorer 2-year survival for those without residual disease after PDS.
Nationwide population-based study of women with EOC FIGO stages IIIC-IV, registered 2008-2018 in the Swedish Quality Register for Gynecologic Cancer, treated with PDS and chemotherapy. TTC was categorized into; ≤21 days, 22-28 days, 29-35 days, 36-42 days and > 42 days. Relative survival (RS) was estimated using the Pohar-Perme estimate of net survival. Multivariable analyses of excess mortality rate ratios (EMRRs) were estimated by Poisson regression models.
In total, 1694 women were included. The median age was 65.0 years. Older age and no residual disease were more common in TTC >42 days than 0-21 days. The RS at 5-years was 37.9% and did not differ between TTC groups. In the R0 (no residual disease) cohort (n = 806), 2-year RS was higher in TTC ≤21 days (91.6%) and 22-28 days (91.4%) than TTC >42 days (79.1%). TTC >42 days (EMRR 2.33, p = 0.026), FIGO stage IV (EMRR 1.83, p = 0.007) and non-serous histology (EMRR 4.20, p < 0.001) were associated with 2-year worse excess mortality compared to TTC 0-21 days, in the R0 cohort. TTC was associated with 2-year survival in the R0 cohort in FIGO stage IV but not in stage IIIC. TTC was not associated with RS in patients with residual disease.
For the entire cohort, stage IV, non-serous morphology and residual disease, but not TTC, influenced 5-year relative survival. However, longer TTC was associated with a poorer 2-year survival for those without residual disease after PDS.
摘要：
目的：本研究的目的是研究原发性切除手术（PDS）后开始化疗（TTC）的时间是否会影响晚期上皮性卵巢/输卵管/原发性腹膜癌（EOC）的相对生存率（RS）。
方法：全国基于人群的EOCFIGOIIIC-IV期女性研究，2008-2018年在瑞典妇科癌症质量登记册中注册，用PDS和化疗治疗。TTC分为；≤21天，22-28天,29-35天,36-42天和>42天。使用Pohar-Perme对净生存率的估计来估计相对生存率(RS)。通过泊松回归模型估计超额死亡率比率（EMRR）的多变量分析。
结果：总计，包括1694名妇女。中位年龄为65.0岁。年龄较大且无残留病的TTC>42天比0-21天更常见。5年的RS为37.9%，TTC组之间没有差异。在R0（无残留疾病）队列中（n=806），TTC≤21天（91.6％）和22-28天（91.4％）的2年RS高于TTC>42天（79.1％）。TTC>42天（EMRR2.33，p=0.026），与TTC0-21天相比，FIGOIV期（EMRR1.83，p=0.007）和非浆液性组织学（EMRR4.20，p<0.001）与2年更差的超额死亡率相关，在R0队列中。在FIGOIV期的R0队列中，TTC与2年生存率相关，而在IIIC期则不相关。残留病变患者的TTC与RS无关。
结论：对于整个队列，第四阶段,非浆液形态和残留病，但不是TTC,影响5年相对生存率。然而,对于PDS后无残留疾病的患者,TTC时间越长,2年生存率越差.
方法：全国基于人群的EOCFIGOIIIC-IV期女性研究，2008-2018年在瑞典妇科癌症质量登记册中注册，用PDS和化疗治疗。TTC分为；≤21天，22-28天,29-35天,36-42天和>42天。使用Pohar-Perme对净生存率的估计来估计相对生存率(RS)。通过泊松回归模型估计超额死亡率比率（EMRR）的多变量分析。
结果：总计，包括1694名妇女。中位年龄为65.0岁。年龄较大且无残留病的TTC>42天比0-21天更常见。5年的RS为37.9%，TTC组之间没有差异。在R0（无残留疾病）队列中（n=806），TTC≤21天（91.6％）和22-28天（91.4％）的2年RS高于TTC>42天（79.1％）。TTC>42天（EMRR2.33，p=0.026），与TTC0-21天相比，FIGOIV期（EMRR1.83，p=0.007）和非浆液性组织学（EMRR4.20，p<0.001）与2年更差的超额死亡率相关，在R0队列中。在FIGOIV期的R0队列中，TTC与2年生存率相关，而在IIIC期则不相关。残留病变患者的TTC与RS无关。
结论：对于整个队列，第四阶段,非浆液形态和残留病，但不是TTC,影响5年相对生存率。然而,对于PDS后无残留疾病的患者,TTC时间越长,2年生存率越差.
