Abstract
BackgroundRecent phase III randomized trials have suggested that neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS) is a treatment option for patients with advanced epithelial ovarian cancer. This study aimed to use CA-125 and computed tomography (CT) scanning to generate a simple and clinically applicable model of predicting complete cytoreduction by interval debulking surgery (IDS) and the overall survival in patients who receive taxane/platinum-based chemotherapy as neoadjuvant chemotherapy (NACT).MethodsPatients with stage IIIc or IV epithelial ovarian cancer who underwent taxane/platinum-based NACT followed by IDS in Gunma Prefectural Cancer Center, Takasaki General Medical Center, and Gunma University from April 2009 to March 2015 were included. Patients underwent a CT scan to confirm confirm tumors unresectable by standard surgery before NACT. CA-125 levels were measured pre-NACT, after each cycle of NACT, and before IDS. CT was also performed before IDS to evaluate tumor metastasis. Data were collected retrospectively and analyzed to determine the predictive factors of complete resection and overall survival.ResultsAmong 63 patients who received NACT-IDS, 43 and 20 patients had stages IIIc and IV epithelial ovarian cancer at diagnosis, respectively. CT predictors of residual tumors after IDS such as extra-ovarian implants (P = 0.009) and omental cakes (P = 0.038) were not present. Univariate analysis revealed that the independent factors for overall survival were no residual tumor by IDS (P = 0.0016) and CA125 ≤ 20 U/ml before IDS (P = 0.0011).ConclusionsAlthough this study had a small sample size, NACT-IDS used to completely remove macroscopic disease which significantly improved the prognosis of patients with preoperative CA-125 ≤ 20 U/ml. Results from this study provide useful information for future studies on the management of patients with advanced epithelial ovarian cancer.
Highlights
Recent phase III randomized trials have suggested that neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS) is a treatment option for patients with advanced epithelial ovarian cancer
Since two randomized controlled trials (RCT) [1, 2] have reported the non-inferior survival of neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS) compared to primary debulking surgery (PDS), the use of NACT-IDS for advanced epithelial ovarian cancer (EOC) has increased
The number of NACT cycles was not related to the residual tumor status after IDS (P = 0.93), one patient from both groups received more than 10 NACT cycles to meet the criteria described in the Methods section
Summary
Recent phase III randomized trials have suggested that neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS) is a treatment option for patients with advanced epithelial ovarian cancer. Since two randomized controlled trials (RCT) [1, 2] have reported the non-inferior survival of neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS) compared to PDS, the use of NACT-IDS for advanced EOC has increased. Numerous retrospective studies and meta-analyses have found that patients with neoadjuvant chemotherapy (NACT) who had complete removal of all macroscopic tumors had an increased survival advantage [3,4,5,6,7]. The best method of evaluating which patients will benefit from NACT-IDS remains controversial
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
