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Validation of a New Prognostic Score in Patients with Ovarian Adenocarcinoma

Background and Objectives: This study aimed to assess the impact of clinical prognostic factors and propose a prognostic score that aids the clinician’s decision in estimating the risk for patients in clinical practice. Materials and Methods: The study included 195 patients diagnosed with ovarian ad...

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Autores principales: Trifanescu, Oana Gabriela, Mitrica, Radu Iulian, Gales, Laurentia Nicoleta, Marinescu, Serban Andrei, Motas, Natalia, Trifanescu, Raluca Alexandra, Rebegea, Laura, Gherghe, Mirela, Georgescu, Dragos Eugen, Serbanescu, Georgia Luiza, Bashar, Haj Hamoud, Dragosloveanu, Serban, Cristian, Daniel Alin, Anghel, Rodica Maricela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9967083/
https://www.ncbi.nlm.nih.gov/pubmed/36837431
http://dx.doi.org/10.3390/medicina59020229
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author Trifanescu, Oana Gabriela
Mitrica, Radu Iulian
Gales, Laurentia Nicoleta
Marinescu, Serban Andrei
Motas, Natalia
Trifanescu, Raluca Alexandra
Rebegea, Laura
Gherghe, Mirela
Georgescu, Dragos Eugen
Serbanescu, Georgia Luiza
Bashar, Haj Hamoud
Dragosloveanu, Serban
Cristian, Daniel Alin
Anghel, Rodica Maricela
author_facet Trifanescu, Oana Gabriela
Mitrica, Radu Iulian
Gales, Laurentia Nicoleta
Marinescu, Serban Andrei
Motas, Natalia
Trifanescu, Raluca Alexandra
Rebegea, Laura
Gherghe, Mirela
Georgescu, Dragos Eugen
Serbanescu, Georgia Luiza
Bashar, Haj Hamoud
Dragosloveanu, Serban
Cristian, Daniel Alin
Anghel, Rodica Maricela
author_sort Trifanescu, Oana Gabriela
collection PubMed
description Background and Objectives: This study aimed to assess the impact of clinical prognostic factors and propose a prognostic score that aids the clinician’s decision in estimating the risk for patients in clinical practice. Materials and Methods: The study included 195 patients diagnosed with ovarian adenocarcinoma. The therapeutic strategy involved multidisciplinary decisions: surgery followed by adjuvant chemotherapy (80%), neoadjuvant chemotherapy followed by surgery (16.4%), and only chemotherapy in selected cases (3.6%). Results: After a median follow-up of 68 months, in terms of progression-free survival (PFS) and overall survival (OS), Eastern Cooperative Oncology Group (ECOG) performance status of 1 and 2 vs. 0 (hazard ratio—HR = 2.71, 95% confidence interval—CI, 1.96–3.73, p < 0.001 for PFS and HR = 3.19, 95%CI, 2.20–4.64, p < 0.001 for OS), menopausal vs. premenopausal status (HR = 2.02, 95%CI, 1.35–3,0 p < 0.001 and HR = 2.25, 95%CI = 1.41–3.59, p < 0.001), ascites (HR = 1.95, 95%CI 1.35–2.80, p = 0.03, HR = 2.31, 95%CI = 1.52–3.5, p < 0.007), residual disease (HR = 5.12, 95%CI 3.43–7.65, p < 0.0001 and HR = 4.07, 95%CI = 2.59–6.39, p < 0.0001), and thrombocytosis (HR = 2.48 95%CI = 1.72–3.58, p < 0.0001, HR = 3.33, 95%CI = 2.16–5.13, p < 0.0001) were associated with a poor prognosis. An original prognostic score including these characteristics was validated using receiver operating characteristic (ROC) curves (area under the curve—AUC = 0.799 for PFS and AUC = 0.726 for OS, p < 0.001). The median PFS for patients with none, one, two, three, or four (or more) prognostic factors was not reached, 70, 36, 20, and 12 months, respectively. The corresponding median overall survival (OS) was not reached, 108, 77, 60, and 34 months, respectively. Conclusions: Several negative prognostic factors were identified: ECOG performance status ≥ 1, the presence of ascites and residual disease after surgery, thrombocytosis, and menopausal status. These led to the development of an original prognostic score that can be helpful in clinical practice.
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spelling pubmed-99670832023-02-26 Validation of a New Prognostic Score in Patients with Ovarian Adenocarcinoma Trifanescu, Oana Gabriela Mitrica, Radu Iulian Gales, Laurentia Nicoleta Marinescu, Serban Andrei Motas, Natalia Trifanescu, Raluca Alexandra Rebegea, Laura Gherghe, Mirela Georgescu, Dragos Eugen Serbanescu, Georgia Luiza Bashar, Haj Hamoud Dragosloveanu, Serban Cristian, Daniel Alin Anghel, Rodica Maricela Medicina (Kaunas) Article Background and Objectives: This study aimed to assess the impact of clinical prognostic factors and propose a prognostic score that aids the clinician’s decision in estimating the risk for patients in clinical practice. Materials and Methods: The study included 195 patients diagnosed with ovarian adenocarcinoma. The therapeutic strategy involved multidisciplinary decisions: surgery followed by adjuvant chemotherapy (80%), neoadjuvant chemotherapy followed by surgery (16.4%), and only chemotherapy in selected cases (3.6%). Results: After a median follow-up of 68 months, in terms of progression-free survival (PFS) and overall survival (OS), Eastern Cooperative Oncology Group (ECOG) performance status of 1 and 2 vs. 0 (hazard ratio—HR = 2.71, 95% confidence interval—CI, 1.96–3.73, p < 0.001 for PFS and HR = 3.19, 95%CI, 2.20–4.64, p < 0.001 for OS), menopausal vs. premenopausal status (HR = 2.02, 95%CI, 1.35–3,0 p < 0.001 and HR = 2.25, 95%CI = 1.41–3.59, p < 0.001), ascites (HR = 1.95, 95%CI 1.35–2.80, p = 0.03, HR = 2.31, 95%CI = 1.52–3.5, p < 0.007), residual disease (HR = 5.12, 95%CI 3.43–7.65, p < 0.0001 and HR = 4.07, 95%CI = 2.59–6.39, p < 0.0001), and thrombocytosis (HR = 2.48 95%CI = 1.72–3.58, p < 0.0001, HR = 3.33, 95%CI = 2.16–5.13, p < 0.0001) were associated with a poor prognosis. An original prognostic score including these characteristics was validated using receiver operating characteristic (ROC) curves (area under the curve—AUC = 0.799 for PFS and AUC = 0.726 for OS, p < 0.001). The median PFS for patients with none, one, two, three, or four (or more) prognostic factors was not reached, 70, 36, 20, and 12 months, respectively. The corresponding median overall survival (OS) was not reached, 108, 77, 60, and 34 months, respectively. Conclusions: Several negative prognostic factors were identified: ECOG performance status ≥ 1, the presence of ascites and residual disease after surgery, thrombocytosis, and menopausal status. These led to the development of an original prognostic score that can be helpful in clinical practice. MDPI 2023-01-26 /pmc/articles/PMC9967083/ /pubmed/36837431 http://dx.doi.org/10.3390/medicina59020229 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Trifanescu, Oana Gabriela
Mitrica, Radu Iulian
Gales, Laurentia Nicoleta
Marinescu, Serban Andrei
Motas, Natalia
Trifanescu, Raluca Alexandra
Rebegea, Laura
Gherghe, Mirela
Georgescu, Dragos Eugen
Serbanescu, Georgia Luiza
Bashar, Haj Hamoud
Dragosloveanu, Serban
Cristian, Daniel Alin
Anghel, Rodica Maricela
Validation of a New Prognostic Score in Patients with Ovarian Adenocarcinoma
title Validation of a New Prognostic Score in Patients with Ovarian Adenocarcinoma
title_full Validation of a New Prognostic Score in Patients with Ovarian Adenocarcinoma
title_fullStr Validation of a New Prognostic Score in Patients with Ovarian Adenocarcinoma
title_full_unstemmed Validation of a New Prognostic Score in Patients with Ovarian Adenocarcinoma
title_short Validation of a New Prognostic Score in Patients with Ovarian Adenocarcinoma
title_sort validation of a new prognostic score in patients with ovarian adenocarcinoma
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9967083/
https://www.ncbi.nlm.nih.gov/pubmed/36837431
http://dx.doi.org/10.3390/medicina59020229
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