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. 2018 Jul;29(4):e63.
doi: 10.3802/jgo.2018.29.e63. Epub 2018 Apr 18.

Impact of increased utilization of neoadjuvant chemotherapy on survival in patients with advanced ovarian cancer: experience from a comprehensive cancer center

Yong Jae Lee  1 , Young Shin Chung  1 , Jung Yun Lee  1 , Eun Ji Nam  1 , Sang Wun Kim  1 , Sunghoon Kim  2 , Young Tae Kim  1
Affiliations

Impact of increased utilization of neoadjuvant chemotherapy on survival in patients with advanced ovarian cancer: experience from a comprehensive cancer center

Yong Jae Lee et al. J Gynecol Oncol. 2018 Jul.

Abstract

Objective: The choice between primary debulking surgery (PDS) and neoadjuvant chemotherapy (NAC) in advanced ovarian cancer remains controversial. We evaluated NAC use in our center before and after results from a randomized trial were published, with the aim to determine the impact of changes in the neoadjuvant strategy on survival in advanced-stage ovarian cancer.

Methods: We retrospectively investigated the clinical course of 435 patients with ovarian, tubal, or peritoneal carcinoma (International Federation of Gynecology and Obstetrics [FIGO] stage III or IV). According to the period of treatment, we stratified patients into a control group (n=216; diagnosed between 2006 and 2010; 83.8% underwent PDS) and a study group (n=219; diagnosed between 2011 and 2014; 48.9% received NAC followed by interval debulking surgery [IDS]).

Results: There were no between-group differences in age, body mass index, histology findings, or tumor grade. Compared to patients in the control group, those in the study group were more likely to receive NAC followed by IDS as first-line treatment (48.9% vs. 16.2%; p<0.001), cytoreductive surgery to no-residual disease (21.5% vs. 10.2%; p<0.001), or radical surgery (57.5% vs. 35.6%; p<0.001). However, there was no between-group difference in postoperative morbidity. Kaplan-Meier analysis showed no between-group differences in progression-free or overall survival (p=0.449 and 0.952, respectively).

Conclusion: NAC incorporation resulted in increased optimal cytoreduction rates although no significant differences in survival outcomes were noted. NAC is advantageous for patients with high perioperative morbidity or unresectable disease.

Keywords: Chemotherapy, Adjuvant; Debulking Surgical Procedure; Neoadjuvant Therapy; Ovarian Neoplasms.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Change in NAC use between 2006 and 2014. NAC, neoadjuvant chemotherapy; PDS, primary debulking surgery.
Fig. 2
Fig. 2
Kaplan-Meier curves of PFS (A) and OS (B) according to time period (2006–2010 vs. 2011–2014). OS, overall survival; PFS, progression-free survival.
See this image and copyright information in PMC

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