Assessment of prognostic significance of unique tumor regression scoring system in advanced epithelial ovarian cancer patients treated with neoadjuvant chemotherapy followed by interval debulking surgery -Single tertiary care center experience

Abstract

Aim and Objective: To assess the prognostic significance of pathological factors and the use of unique tumour regression scoring system over survival in advanced epithelial ovarian cancer patients treated with neoadjuvant chemotherapy (NAC) and Interval debulking surgery. Materials and Methods: We retrospectively investigated 135 patients from January 2011 to December 2017 received minimum of 3 cycles of NAC followed by interval debulking surgery (IDS) and their resected specimens were divided into 3 groups based on pathological tumour regression: Group 1: minimal response (residual disease with necrosis and fibrosis 50%) and Group 3: complete response (No residual disease). The clinico-pathological parameters and their prognostic influence over survival outcomes were assessed using Statistical Package for the Social Sciences (SPSS 21.0) software and a p value of Results: Histopathological tumour regression groups 1, 2 and 3 were significantly associated with histological grade, presence of residual disease in ovary with involvement of lymph node, omentum. DFS and overall survival were 42.0±8.0 and 47.1 ± 5.4 months respectively. The overall median survival in FIGO stage III patients was better than FIGO IV stage. Conclusion: This proposed 3 simple criterions of histopathological tumour regression has prognostic significance in association with clinical stage and amount of residual disease in resected specimen. This simplified unique tumour regression system may serve in the future as highly valuable prognostic tool, which needs further validation. Keywords: Advanced ovarian malignancy, Neoadjuvant chemotherapy, Interval debulking surgery, Tumour regression system.