Abstract
Background: Neoadjuvant chemotherapy is used in gynecologic malignancies as primary treatment for advanced disease and has demonstrated improvement in survival rates. However, the data for use in endometrial cancer is limited. Case: This is a case of stage IV endometrial undifferentiated carcinoma with complete response to four cycles of neoadjuvant chemotherapy (carboplatin/paclitaxel) and no evidence of disease during the interval debulking surgery (robotic-assisted total laparoscopic hysterectomy with bilateral salpingoophorectomy, pelvic and paraaortic lymph node dissection, and cystoscopy). Conclusion: Complete response to neoadjuvant chemotherapy prior to interval debulking surgery is only reported in a limited number of cases, and even less common in advanced stage high-grade endometrial cancers. The use of neoadjuvant chemotherapy may reduce tumor burden, increase opportunities for optimal debulking, and have an impact on survival. Further research is needed to understand the potential for neoadjuvant chemotherapy in these patients.
Highlights
Case: This is a case of stage IV endometrial undifferentiated carcinoma with complete response to four cycles of neoadjuvant chemotherapy and no evidence of disease during the interval debulking surgery
European trials for advanced stage epithelial ovarian cancer (EOC) have shown that the progression free survival (PFS) and overall survival (OS) in patients who had neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) are non-inferior to patients who underwent primary cytoreductive surgery [1]
Chemotherapy, and radiation are all considered in the treatment regimen for endometrial cancer
Summary
The main treatment modality for advanced stage endometrial cancer is primary cytoreductive surgery. European trials for advanced stage EOC have shown that the progression free survival (PFS) and overall survival (OS) in patients who had NACT followed by interval debulking surgery (IDS) are non-inferior to patients who underwent primary cytoreductive surgery [1]. Patients with advanced stage EOC who underwent NACT and IDS demonstrated lower rates of surgical mortality and higher optimal or complete debulking.
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