Post-operative Residual Disease and Number of Cycles of Neoadjuvant Chemotherapy in Advanced Epithelial Ovarian Carcinoma

Overview

Journal Int J Gynecol Cancer

Specialties Gynecology & Obstetrics
Oncology

Date 2023 Jul 10

PMID 37429642

Authors

Anna Myriam Perrone

Camelia Alexandra Coada

Gloria Ravegnini

Antonio De Leo

Giuseppe Damiano

Eugenia De Crescenzo

Marco Tesei

Stella Di Costanzo

Lucia Genovesi

Daniela Rubino

Claudio Zamagni

Pierandrea De Iaco

Affiliations

Soon will be listed here.

Abstract

Background: The optimal number of neoadjuvant chemotherapy cycles in patients with advanced ovarian cancer is still disputed.

Objective: To evaluate the impact of the number of neoadjuvant chemotherapy cycles and role of optimal cytoreduction on the prognosis of patients with advanced ovarian cancer.

Methods: Clinical and pathological details were examined. Patients were evaluated combining the number of cycles of neoadjuvant chemotherapy-namely, 'interval debulking surgery' after up to four neoadjuvant chemotherapy cycles, and 'delayed debulking surgery' after more than four cycles of therapy.

Results: A total of 286 patients were included in the study. Complete cytoreduction with no residual peritoneal disease (CC0) was achieved in 74 (74%) patients with interval debulking surgery and 124 (66.7%) patients with delayed interval debulking. Of those with residual disease, there were 26/88 (29.5%) patients in the interval debulking surgery group and 62/88 (70.5%) patients in the delayed debulking surgery group. Comparison of patients with delayed debulking-CC0 and interval debulking-CC0 showed no difference in progression-free survival (p=0.3) or overall survival (p=0.4), while significantly worse outcomes were observed in patients with interval debulking-CC1 (p=0.02 and p=0.04, respectively). Specifically, patients with interval debulking-CC1 had an approximately 67% increased risk of disease progression (p=0.04; HR=2.01 (95% CI 1.04 to 4.18)) and a 69% higher risk of death than patients with delayed debulking-CC0 (p=0.03; HR=2.34 (95% CI 1.11 to 4.67)).

Conclusion: Increasing the number of neoadjuvant chemotherapy cycles does not worsen patient outcomes if complete resection is achieved. Nevertheless, additional prospective trials are necessary to establish the optimum number of neoadjuvant chemotherapy cycles.

Citing Articles

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