71 Neoadjuvant chemotherapy in epithelial ovarian cancer: a case-control study in a Lebanese tertiary care center

Abstract

Objectives We aim to compare the outcomes of patients with epithelial ovarian carcinoma treated with neoadjuvant chemotherapy to those with primary debulking surgery. Methods A retrospective case-control study was conducted at a Hotel-Dieu de France University Hospital. We reviewed the clinipathological data of 184 patients who were operated on for an epithelial ovarian cancer and we compared the outcomes of patients who received a neoadjuvant chemotherapy (n=94) with those treated with primary surgery(n=90). Results Patients in both groups had comparable age, menopausal status and comorbidities (p>0.05). Patients receiving neoadjuvant chemotherapy had more serous histology and high-grade lesions (58,1% vs. 41,9% (p=0.003), 58,8% vs. 41,2% (p=0.005), respectively). Bilateral adnexal involvement was more seen in the neoadjuvant group (57,4% vs. 42,6%, p=0.19). Patients receiving neoadjuvant chemotherapy were more likely to present lymph node involvement (61,1% vs. 38,9%, p=0.006). More bowel resection was done in the neoadjuvant group (62,4% vs. 37,6%, p=0.005). Postoperative complications were comparable between the two groups (p=0.441). Interval surgery group received more blood transfusion as primary surgery group (55,7% vs. 44,3%, p=0.004). Survival rate was 41,8% in the interval surgery group vs. 58,2% in the primary surgery group (p=0.000). Recurrence rate 60% in the interval surgery group vs. 40% in the primary surgery group (p=0.025). No difference in the recurrence interval was seen in both groups (p=0.272). Conclusion Patients with ovarian cancer receiving neoadjuvant chemotherapy seem to have more aggressive disease and do not have better outcomes in terms of survival and recurrence in comparison to primary surgery group.