Surgical and Survival Outcomes with Neoadjuvant Chemotherapy in Advanced Epithelial Ovarian Cancer: A Longitudinal Study in a Tertiary Cancer Center
Rekha B Raghavendrachar, Rani A Bhat, Vibhawari Dhakaria
Citation Information :
Raghavendrachar RB, Bhat RA, Dhakaria V. Surgical and Survival Outcomes with Neoadjuvant Chemotherapy in Advanced Epithelial Ovarian Cancer: A Longitudinal Study in a Tertiary Cancer Center. J South Asian Feder Obs Gynae 2020; 12 (1):27-30.
Aims: To evaluate surgical and survival outcomes following neoadjuvant chemotherapy followed by interval debulking surgery (IDS) in advanced epithelial ovarian cancer (AEOCs). Materials and methods: Fifty patients who were diagnosed with stage III–IV ovarian cancer/primary peritoneal cancer/fallopian tube cancer were followed up following three cycles of neoadjuvant chemotherapy and debulking surgery followed by adjuvant chemotherapy in a comprehensive cancer center. This longitudinal study was conducted over four years from 2013–2017. Primary outcome measured was progression-free survival and secondary outcomes that included overall survival and effect of optimal and suboptimal surgeries on survival outcomes. In this study, we compared the difference in survival outcomes following various types of debulking (complete vs optimal vs suboptimal). Results: Among 50 patients who underwent debulking, 78%, 8%, and 14% underwent complete, optimal, and suboptimal debulking, respectively. The mean estimate of progression-free survival (PFS) at 24 months was 20.324 ± 0.97 months (95% CI) and the overall survival was 21.234 ± 0.788 months. There was a significant increase in PFS in those who had complete debulking (21.47 ± 0.95 months, 95% CI 19.6 to 23.3 months) compared to those in optimal debulking (20.53 months) and suboptimal groups (10.3 months) (Log-rank Mantel–Cox = 12.01, p = 0.001). Seventy-eight percent had no postoperative complications while 16% had grade I complications. Grade II, IV, and V complications were 2% each. Conclusion: Neoadjuvant chemotherapy followed by IDS gives better chance of complete debulking and better survival outcomes with acceptable postoperative complications.
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