Survival analysis of second-line chemotherapy in platinum-sensitive relapsed ovarian cancer patients

Background Patients of ovarian cancer who respond to the initial chemotherapy (CT) regimen may respond again to the same drugs after relapse. We aimed to evaluate the survival of patients with recurrent ovarian cancer (ROC) treated with second-line CT drugs such as liposomal doxorubicin, paclitaxel/carboplatin, and/or bevacizumab. Methods Electronic medical records of ovarian cancer patients registered between January 2009 and December 2017 were reviewed to identify those with ROC. Data regarding demographics, clinical characteristics, treatment, recurrence, vital status at last contact, etc. were retrieved. The log-rank test was applied to compare the Kaplan-Meier curves for survival analysis. Results A total of 119 cases met the inclusion criteria. The median age at diagnosis and relapse was 49 and 51 years, respectively. The medians for progression-free survival (PFS) and post-relapse survival (PRS) were 19 (95% CI 10.34-21.66) months and 34 (95% CI 37.17-56.83) months, respectively. The PFS was significantly higher among premenopausal women (p=0.025). Patients treated with paclitaxel/carboplatin-based second-line CT had significantly higher PRS compared to those treated with liposomal doxorubicin/carboplatin (p<0.001). Overall survival was also significantly different between the stage groups (p=0.003). Conclusions The 5-year PFS rate in ROC treated with second-line CT is <20%. The rate of secondary recurrence is moderately high, leading to reduced survival. Paclitaxel/carboplatin-based second-line CT significantly increases PRS among ROC patients. The probability of mortality increases as the stage advances.