Evidence map›Paper›PMID 40643609›Full record

ArticleArchives of gynecology and obstetrics2025

Earlier is not always better: Optimal time to initiate adjuvant chemotherapy after surgery for ovarian cancer.

Philipp Meyer-Wilmes, Lieven Nils Kennes, Atanas Ignatov, Franziska Goetz, Julia Wittenborn, Elmar Stickeler, Svetlana Nikolayevna Tchaikovski

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Article in Archives of gynecology and obstetrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Philipp Meyer-WilmesDepartment of Obstetrics and Gynecology, Center for Integrated Oncology (CIO Aachen, Bonn, Cologne, Düsseldorf), University Hospital of RWTH Aachen, Aachen, Germany.
Lieven Nils KennesDepartment of Economics and Business Administration, Stralsund University of Applied Sciences, Stralsund, Germany.
Atanas IgnatovDepartment of Gynaecology and Obstetrics, Otto-Von-Guericke University, Magdeburg, Germany.
Franziska GoetzDepartment of Obstetrics and Gynecology, Center for Integrated Oncology (CIO Aachen, Bonn, Cologne, Düsseldorf), University Hospital of RWTH Aachen, Aachen, Germany.
Julia WittenbornDepartment of Obstetrics and Gynecology, Center for Integrated Oncology (CIO Aachen, Bonn, Cologne, Düsseldorf), University Hospital of RWTH Aachen, Aachen, Germany.
Elmar StickelerDepartment of Obstetrics and Gynecology, Center for Integrated Oncology (CIO Aachen, Bonn, Cologne, Düsseldorf), University Hospital of RWTH Aachen, Aachen, Germany.
Svetlana Nikolayevna TchaikovskiDepartment of Gynaecology and Obstetrics, Otto-Von-Guericke University, Magdeburg, Germany. svetlana.tchaikovski@uk-brandenburg.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTumor resection followed by adjuvant chemotherapy constitutes the cornerstone of ovarian cancer (OC) treatment. This study aimed to evaluate the impact of the time to chemotherapy (TTC) after primary surgery on the survival outcomes of patients with OC.

methodsPatients with OC at any stage who underwent primary surgery followed by adjuvant chemotherapy between 2000 and 2021 were included in the analysis. Data were obtained from the Cancer Registries of Aachen and nine hospitals in Saxony-Anhalt. Patients were stratified into three subgroups based on the timing of chemotherapy initiation: early (≤ 21 days), intermediate (22-35 days) and late (> 35-180 days). The impact of TTC on progression-free survival (PFS) and overall survival (OS) was assessed using multivariate Cox proportional hazard models, both in complete case analysis and with multivariate imputation by chained equations to account for missing data.

resultsA total of 1699 patients with OC (mean age: 61.4 ± 12 years) started adjuvant chemotherapy 32.2 ± 24.6 days after surgery. For OS, the optimal TTC was identified at 26 days post-surgery. Compared with the intermediate group, both earlier and later initiation of chemotherapy were associated with worsened OS (Hazard Ratio (HR) = 1.34, 95%CI 1.23-1.60, p < 0.05 and HR = 1.38 95%CI 1.14 -1.68; p < 0.001, respectively).

conclusionThe optimal timing for initiating adjuvant chemotherapy appears to be between 22 and 35 days after primary surgery for ovarian cancer. Remarkably, an earlier start of chemotherapy did not confer a survival advantage, possibly due to the need for adequate recovery after surgery.

Indexed as

Ovarian NeoplasmsTime-to-TreatmentAdultAgedChemotherapy, AdjuvantFemaleHumansMiddle AgedProgression-Free SurvivalProportional Hazards ModelsRegistriesRetrospective StudiesTime FactorsGynecologic cancerReal world dataSurgerySurvivalTime to chemotherapy

Identifiers

PMID40643609
PMCPMC12414076

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