06 0 59-1 88 0 85         Surgery (complete vs non complete) 52 0

06 0.59-1.88 0.85         Surgery (complete vs non complete) 52 0.29 0.15-.058 4.97 E-07 51 0.43 0.19-0.94 0.034 Complete clinical remission (Yes vs No) 51 0.22 0.11-0.45 3.65 E-05 51 0.33 0.15-0.74 0.007 CA-125 (normal vs >normal) 44 1.87 0.84-4.16 0.12         Treatment (CCA vs HDC) 52 2.44 1.14-5.25 0.02 51 2.31 1.06-5.04 0.036 PFS, progression-free

survival; N, number of cases with data available; 95CI, 95% confidence interval; HR, hazard ratio; OMS, performance status; CCA, conventional chemotherapy alone; HDC, high-dose chemotherapy. We then explored the impact of chemotherapy regimen on OS according to the two factors independently associated ACP-196 cost with a PFS improvement induced by HDC (young age and FIGO stage IIIc). We could ABT-737 solubility dmso observe that HDC plus HSCS significantly improved survival only when age was under 50 years, but not in stage IIIc patients (Figure 4). Median overall survival was highly increased in young patients treated with HDC (54.6 months) when compared to conventional therapy alone (36 months), (p=0.05). Effect of HDC according to FIGO stage IIIc was less important and non significant: median OS was 53.9 months in the HDC subset versus 41.3 months in the CCA subset (p=0.11). Figure 4 Overall survival after conventional chemotherapy alone (black) or

plus high dose chemotherapy (grey). (A) In patients under 50 years of age (n=52) median OS was 36 months in the CCA subset versus 54.6 months in the HDC subset; (B) in stage IIIc cases (n=129) median OS was 42 months in the CCA subset versus 49.5 months in the HDC subset; + censored data. It is worth to note that the prognostic value of HDC was not modified by the initial response to treatment. HDC improved survival in young patients whatever the response to initial therapy was: median PFS was 5 months for CCA vs. 15 months

for HDC in patients with residual disease after treatment; and 38 months for CCA whereas it had not been reached after a follow-up of 47 months in the HDC group for cases with initial CCR and CA-125 normalization. Discussion Even though HDC plus HSCS cannot be considered as a standard of care for all AOC patients, results from this monocentric comparative FER retrospective study including 163 patients suggest that it may be beneficial to young patients. In women under 50 years of age, addition of HDC to platinum/taxane-based chemotherapy improves not only PFS (p=0.02), but also OS (median of 54.6 months versus 36 months with conventional therapy alone, p=0.05). Despite advances in chemotherapy and multidisciplinary management of ovarian carcinomas, the prognosis of patients with advanced stages (FIGO III/IV) remains poor. Median PFS and OS of our cohort treated with a platinum/taxane combination alone (18.1 and 41.3 months, respectively) were similar to those of phase III pivotal studies: 18 and 38 months [10], and 19.4 and 48.7 months [6] with cisplatin and paclitaxel; 20.7 and 57.4 months for carboplatin and paclitaxel [6].

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