Patterns of Recurrence in Patients Treated With Bevacizumab in the Primary Treatment of Advanced Epithelial Ovarian Cancer

Rauh-Hain, Jose Alejandro MD*; Guseh, Stephanie H. MD*†; Esselen, Katharine M. MD, MBA; Growdon, Whitfield B. MD*; Schorge, John O. MD*; Horowitz, Neil S. MD; Krasner, Carolyn N. MD; del Carmen, Marcela G. MD, MPH*; Birrer, Michael J. MD, PhD; Dizon, Don S. MD

International Journal of Gynecological Cancer: September 2013 - Volume 23 - Issue 7 - p 1219–1225
doi: 10.1097/IGC.0b013e31829f17c9
Ovarian Cancer

Objective: The purpose of this study was to compare the distribution of the first site of recurrence in patients with epithelial ovarian cancer (EOC) who received first-line treatment with bevacizumab compared with patients who did not receive bevacizumab.

Methods: From the Cancer Registry database at our institutions, we identified a group of patients with recurrent EOC who underwent treatment from January 1, 2005, to December 31, 2010. Each patient record was evaluated to classify the site of first recurrence. Correlation between categorical variables was assessed with χ2 test.

Results: Two hundred ninety-two patients with advanced EOC (stage III or IV) who originally responded to chemotherapy and had a recurrence were identified. Of these, 37 (12.5%) had received postoperative chemotherapy bevacizumab, and 255 (87.5%) did not. Compared with those not treated with bevacizumab, there was a lower incidence of liver recurrence (0% vs 9%; P = 0.05) and a higher rate of lung and/or pleural recurrence (22% vs 5%; P = 0.001) and recurrence at distant sites (22% vs 9%; P = 0.03) in patients who received bevacizumab. There was no difference in the incidence of ascites at the time of recurrence between these groups.

Conclusions: Patients who received bevacizumab as part of primary treatment for EOC had a higher rate of lung and/or pleural recurrence and a lower rate of liver recurrence. There was no difference in the rate of ascites at the time of recurrence.

*Division of Gynecologic Oncology, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, and †Division of Gynecologic Oncology, Brigham and Women’s Hospital, Harvard Medical School; and ‡Department of Medicine, Massachusetts General Hospital, Boston, MA.

Address correspondence and reprint requests to Don S. Dizon, MD, Division of Gynecologic Oncology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114. E-mail: ddizon@partners.org.

This study has no sources of funding.

The authors declare no conflicts of interest.

Received April 8, 2013

Accepted June 5, 2013

© 2013 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.