Differences in Patterns of Recurrence Between Primary and Interval Debulking Surgery for Advanced Ovarian Cancer

Abstract

Background/aim: This study aimed to identify differences in the pattern and timing of recurrence in patients with advanced ovarian cancer undergoing primary (PDS) or interval debulking surgery after neoadjuvant chemotherapy (NACT).

Patients and methods: Data were prospectively collected on 105 patients from June 2016 to March 2020.

Results: There were 30 (50%) recurrences in the PDS group compared to 32 (72.7%) in the NACT group (p=0.020). An intra-abdominal relapse was more common in NACT compared to PDS patients (64.4% vs. 38.3%, p=0.008) and a recurrence in two or more sites (NACT: 44.4% vs. PDS: 23.3%, p=0.010). Among completely cytoreduced patients, a pelvic recurrence was more frequent in NACT patients (NACT: 50% vs. 22.4% in PDS, p=0.011). Progression-free survival (PFS) was longer in PDS compared to NACT (27 vs. 16 months, p=0.039).

Conclusion: NACT patients experienced an unfavorable distribution and timing of recurrent disease compared to patient who underwent PDS.

Keywords: Recurrence of ovarian cancer; interval debulking surgery; metastasis; primary debulking surgery; progression-free survival.