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Multicenter Study
. 2023 Jun 27;16(1):121.
doi: 10.1186/s13048-023-01164-8.

Timing of interval debulking surgery and postoperative chemotherapy after neoadjuvant chemotherapy in advanced epithelial ovarian cancer: a multicenter real-world study

Xingyu Liu #  1   2 , Yingjun Zhao #  1   2 , Xiaofei Jiao  1   2 , Yang Yu  1   2 , Ruyuan Li  3 , Shaoqing Zeng  1   2 , Jianhua Chi  1   2 , Guanchen Ma  1   2 , Yabing Huo  1   2 , Ming Li  1   2 , Zikun Peng  1   2 , Jiahao Liu  1   2 , Qi Zhou  4   5   6 , Dongling Zou  4   5   6 , Li Wang  7 , Qingshui Li  8 , Jing Wang  9   10 , Shuzhong Yao  11 , Youguo Chen  12 , Ding Ma  1   2 , Ting Hu  13   14   15 , Qinglei Gao  16   17   18
Affiliations
Multicenter Study

Timing of interval debulking surgery and postoperative chemotherapy after neoadjuvant chemotherapy in advanced epithelial ovarian cancer: a multicenter real-world study

Xingyu Liu et al. J Ovarian Res. .

Abstract

Background: To investigate the prognostic relevance of the time to interval debulking surgery (TTS) and the time to postoperative adjuvant chemotherapy (TTC) after the completion of neoadjuvant chemotherapy (NACT).

Methods: A retrospective real-word study included 658 patients with histologically confirmed advanced epithelial ovarian cancer who received NACT at seven tertiary hospitals in China from June 2008 to June 2020. TTS was defined as the time interval from the completion of NACT to the time of interval debulking surgery (IDS). TTC was defined as the time interval from the completion of NACT to the initiation of postoperative adjuvant chemotherapy (PACT).

Results: The median TTS and TTC were 25 (IQR, 20-29) and 40 (IQR, 33-49) days, respectively. Patients with TTS > 25 days were older (55 vs. 53 years, P = 0.012) and received more NACT cycles (median, 3 vs. 2, P = 0.002). Similar results were observed in patients with TTC > 40 days. In the multivariate analyses, TTS and TTC were not associated with PFS when stratified by median, quartile, or integrated as continuous variables (all P > 0.05). However, TTS and TTC were significantly associated with worse OS when stratified by median (P = 0.018 and 0.018, respectively), quartile (P = 0.169, 0.014, 0.027 and 0.012, 0.001, 0.033, respectively), or integrated as continuous variables (P = 0.018 and 0.011, respectively). Similarly, increasing TTS and TTC intervals were associated with a higher risk of death (Ptrend = 0.016 and 0.031, respectively) but not with recurrence (Ptrend = 0.103 and 0.381, respectively).

Conclusion: The delays of IDS and PACT after the completion of NACT have adverse impacts on OS but no impacts on PFS, which indicates that reducing delays of IDS and PACT might ameliorate the outcomes of ovarian cancer patients treated with NACT.

Keywords: Advanced epithelial ovarian cancer; Neoadjuvant chemotherapy; Prognosis; Time to interval debulking surgery; Time to postoperative adjuvant chemotherapy.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Survival analyses according to TTS and TTC. Figure A Kaplan–Meier curves of progression-free survival (A) of TTS. Figure B, Kaplan–Meier curves of overall survival (B) of TTS. Figure  C, Kaplan–Meier curves of progression-free survival (C) of TTC. Figure D, Kaplan–Meier curves of overall survival (D) of TTC. TTS, Time to interval debulking surgery after the completion of neoadjuvant chemotherapy; TTC, Time to postoperative adjuvant chemotherapy after the completion of neoadjuvant chemotherapy; HR, Hazard ratio; CI, Confidence interval
See this image and copyright information in PMC

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