Is chemotherapy-induced neutropenia a prognostic factor in patients with ovarian cancer?

OBJECTIVE: This study sought to determine if relative neutropenia (RN) following six cycles of paclitaxel/carboplatin could serve as a prognostic factor in patients with ovarian cancer.

DESIGN: A single institution, retrospective study.

SETTING: Tertiary academic referral center, Seoul, Korea Population. A total of 179 patients who underwent primary cytoreductive surgery, followed by six cycles of paclitaxel/carboplatin chemotherapy to treat epithelial ovarian cancer.

METHODS: Relative neutropenia was defined by an absolute neutrophil count < 1000 neutrophils/mm(3) at chemotherapy cycle nadir. To eliminate the effects of dose reduction (DR) and schedule delay (SD) on the outcome of analysis, 49 patients who had this were excluded, and a subset analysis of 130 patients who received standard doses and schedules of chemotherapy was performed.

MAIN OUTCOME MEASURES: Progression free and overall survival.

RESULTS: The median progression free survival (PFSs) of neutropenic and non-neutropenic patients was 34 and 22 months, respectively; the median overall survival (OS) times were 67 and 56 months, respectively, with no significant differences in PFS and OS (p = 0.26, 0.59). Multivariate analysis revealed that stage, clear cell histology, and > or =1 cm residual tumor mass were independent prognostic predictors, while RN was not. In the subset analysis confined to the patients without DR and SD, the results were not changed.

CONCLUSION: Chemotherapy-induced neutropenia was not a significant prognostic indicator in ovarian cancer patients treated with paclitaxel/carboplatin as first-line chemotherapy.