Analyze The Influential Factors Of Disease-free Interval In Patients With Recurrent Epithelial Ovarian Cancer

Objective(s): To investigate the related factors of disease free interval(DFI)and the correlation between DFI and overall survival(OS)in recurrent epithelial ovarian cancer(REOC).And by comparing PFS in patients with relapsed disease who had achieved complete or partial response(CR/PR)after initial treatment with an oral poly ADP-ribose polymerase(PARP)inhibitor versus those who had not been maintained with an oral PARP inhibitor,to investigate the effect of PARP inhibitor in first-line maintenance therapy on prolonging PFS in patients with advanced epithelial ovarian cancer.The aim of this study was to investigate the recurrence regularity of EOC,to reduce the recurrence rate,to prolong the disease-free survival and overall survival,and to explore the significance of PARP inhibitors in the first-line maintenance therapy of patients with advanced EOC.Methods: The clinical data of 40 patients with REOC in the Department of Obstetrics and gynecology of kunming university of science and technology in January 2018 and December 2022 were analyzed retrospectively.The influence of 11 factors,including age,Federation International Of Gynecology and Obstetrics(FIGO)stage,histological grade,operative method(laparotomy,laparoscopy),pathological type,lymph node dissection during the first operation,diameter of residual lesion after the first operation,number of chemotherapy courses after the first operation,amount of ascites before operation,preoperative carbohydrate antigen 125(CA125)level and BRCA gene status on DFI were analyzed.All the patients were divided into two groups according to the International Federation of Gynaecology and Obstetrics The PFS outcomes were compared between patients with REOC who received oral PARP inhibitor maintenance therapy after initial treatment reached CR/PR and those who did not receive oral PARP inhibitor maintenance therapy,to investigate the effect of PARP inhibitor,a first-line maintenance therapy,on prolonging PFS in patients with advanced epithelial ovarian cancer.Results:(1)univariate analysis of the influencing factors of DEI suggested that DFI was associated with preoperative ascites ≥500 ml,preoperative CA125>200 u/ml,histological grade,operative method(laparotomy,traditional laparoscopy),FIGO tumor stage,initial lymph node dissection,pathological type,diameter of residual lesion,duration of initial postoperative chemotherapy and BRCA gene status,the difference was statistically significant(p<0.05),and only age had no correlation with DFI(P>0.05).The lower the level of CA125,the less the ascites,the earlier the stage of FIGO tumor and the higher the degree of differentiation of the tumor,the longer the DFI was,the more lymph node dissection was performed during the operation and the full course of chemotherapy was given postoperatively.Multivariate analysis showed that FIGO stage(stage IIB-IV)and residual tumor ≥1 cm after initial operation were independent risk factors for EOC recurrence(P<0.05).(2)there was a positive correlation between DFI and OS in REOC patients(R = 0.863,P<0.05).As DFI increases,OS increases.In total,40 patients had a median OS of 29 months.(3)the median PFS was 31.0 months in patients with advanced EOC who received oral PARP inhibitor maintenance therapy after initial treatment,and 8.5 months in patients who did not receive oral PARP inhibitor maintenance therapy,the difference was statistically significant(p<0.05),suggesting that PARP inhibitor may benefit the survival of patients with advanced EOC.Conclusions:(1)DFI was associated with FIGO clinical stage,pathological type,histological grade,operative method(laparotomy,laparoscopy),lymph node dissection during initial operation,residual lesion size after initial operation,number of chemotherapy courses after initial operation,ascites ≥500ml before treatment,preoperative CA125>200U/ml,BRCA gene status,FIGO stage IIB-IV and residual tumor ≥1 cm after initial operation were the independent influencing factors of recurrence of epithelial ovarian cancer.(2)the longer the DFI was,the longer the OS was.(3)the PFS of patients with advanced EOC treated with oral PARP inhibitor maintenance therapy was significantly longer than that of patients without oral PARP inhibitor maintenance therapy.