Characteristics of Ovarian Cancer Patients on Neoadjuvant Chemotherapy Unable to Have Debulking After 3 Cycles [35E

Abstract

INTRODUCTION: To report on characteristics of patients undergoing neoadjuvant chemotherapy (NACT) for advanced ovarian, fallopian tube, or primary peritoneal carcinoma who did not undergo interval debulking-surgery after three cycles. METHODS: An IRB retrospective cohort study was performed on women undergoing NACT following diagnosis. Abstracted data included demographics, clinicopathologic features, treatment and toxicities. RESULTS: Of 96 identified patients, 30 (31.3%) patients did not undergo surgery after 3 cycles of NACT. Median age was 66.5 (range: 46-85) with median BMI 30.0 (21.2-47.8). Median Charlson Comorbidity Index was 6 (2-11). Median CA-125 was 1240.4 (23.6-11,820). Median baseline albumin was 2 (1.9-4.1). Average neutrophil to lymphocyte ratio was 5.80 (0.9-21.5). Adenocarcinoma was the most common histology (83.3%). 70% of cases were diagnosed with laparoscopy and 20% by cytology. 20% of patients required treatment delays and 33% of patients required hospitalization during treatment. 55% of cases specified residual disease or CA125 elevation for continued treatment as opposed to debulking after 3 cycles. 10.3% of patients required continued therapy due to regimen changes during treatment. CONCLUSION: Patients receiving NACT who did not undergo debulking had a median albumin of <3 along with a significant median comorbidity index. Patients who did not undergo surgery after 3 cycles had significant rates of treatment delay and hospitalization during their treatment course, and the most common cited reason for continued therapy was persistent disease or persistent CA125 elevations.