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. 2013 Dec;63(6):405-9.
doi: 10.1007/s13224-013-0425-z. Epub 2013 Aug 14.

Comparison of Platinum-based Neoadjuvant Chemotherapy and Primary Debulking Surgery in Patients with Advanced Ovarian Cancer

Manizheh Sayyah-Melli  1 , Gita Kashi Zonoozi  2 , Shahryar Hashemzadeh  3 , Ali Esfahani  4 , Elaheh Ouladehsahebmadarek  1 , Mehry Jafary Shobeiry  1 , Parvin Mostafa Garabaghi  1 , Azhough Ramin  5
Affiliations

Comparison of Platinum-based Neoadjuvant Chemotherapy and Primary Debulking Surgery in Patients with Advanced Ovarian Cancer

Manizheh Sayyah-Melli et al. J Obstet Gynaecol India. 2013 Dec.

Abstract

Purpose: Ovarian cancer is the sixth common cancer in women in developed countries. In severe cases, the optimal debulking is necessary. In order to increase optimal debulking and reduce preoperative complications, neoadjuvant chemotherapy followed by debulking surgery, and then chemotherapy again is introduced as substitute for primary surgery. In this study, we aim to evaluate perioperative outcome after neoadjuvant chemotherapy with carboplatin/paclyaxol in comparison with primary cytoreduction in patients with advanced ovarian cancer.

Methods: In this prospective study, 60 patients with advanced ovarian cancer due to the disease severity were assigned into neoadjuvant chemotherapy (n = 30) or control (n = 30) groups. In neoadjuvant chemotherapy group, patients received three cycles of carboplatin (5-6 area under the curve) and paclitaxel (175 mg/m(2)) preoperatively followed by interval surgery. The control group received primary surgery plus adjuvant chemotherapy. Preoperative outcome was compared between groups.

Results: Neoadjuvant group had significantly lower mean levels of CA 125 (p = 0.01) and less severe bleeding (p = 0.03) than control group. There was no significant difference between surgery time, preoperative complications, residual mass less than 1 cm, and hospital stay between groups. There was no mortality during the study.

Conclusion: Neoadjuvant chemotherapy caused less severe bleeding, but has no effect in decreasing complications after surgery; however, neoadjuvant chemotherapy followed by interval debulking surgery was not superior to primary debulking surgery followed by chemotherapy as a treatment option for patients with advanced ovarian carcinoma in this study.

Keywords: Advanced stage; Neoadjuvant chemotherapy; Ovarian cancer; Primary debulking surgery.

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Figures

Fig. 1
Fig. 1
Intraoperative bleeding between NAC and controls
Fig. 2
Fig. 2
The size of residual mass between groups
See this image and copyright information in PMC

References

    1. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2007. CA Cancer J Clin. 2007;57:43–66. doi: 10.3322/canjclin.57.1.43. - DOI - PubMed
    1. Cannistra SA. Cancer of the ovary. N Engl J Med. 2004;351:2519–2529. doi: 10.1056/NEJMra041842. - DOI - PubMed
    1. Yeole BB, Kumar AV, Kurkure A, et al. Population based survival from cancers of breast, cervix and ovary in women in Mumbai, India. Asian Pac J Cancer Prev. 2004;5:308–315. - PubMed
    1. Bristow RE, Tomacruz RS, Armstrong DK, et al. Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a meta-analysis. J Clin Oncol. 2002;20:1248–1259. doi: 10.1200/JCO.20.5.1248. - DOI - PubMed
    1. Du Bois A, Quinn M, Thigpen T, et al. Consensus statements on the management of ovarian cancer: final document of the 3rd International Gynecologic Cancer Intergroup Ovarian Cancer Consensus Conference (GCIG OCCC 2004) Ann Oncol 2005. 2004;16(Suppl 8):viii7–viii12. - PubMed

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