Abstract
e15511 Background: To determine if AS EOC pts evaluated by gynecologic oncologists at one institution and believed not to be surgically cytoreducible (SC) to ≤ 1 cm diameter of residual disease (RD) had a significantly different PFS and OS with NACT (CP) followed by cytoreductive surgery compared to (AS) EOC pts believed to be SC to ≤ 1 cm RD with USC followed by CP. Methods: 221 USC pts (stage IIIC-169, IV-52) and 95 NACT pts (stage III-40, IV-55) treated between 1996 and 2009 were retrospectively reviewed. NACT pts received a median of 6 cycles of C (AUC 6) and P (175 mg/M2) prior to surgery. All NACT pts had imaging findings compatible with AS nonoptimally SC EOC and pathology consistent with EOC. Kaplan-Meier curves were performed for survival analyses. A student T-test was used to compare clinical variables. Results: The PFS and OS for Stage IIIC NACT pts (median 32.5 mos. and 47.5 mos. respectively) was not statistically different than USC pts (median 19.5 and 45.7 mos. respectively; p = 0.099 and 0.918 respectively). The PFS and OS for stage IV NACT pts (median 15.6 and 25.8 mos. respectively) was not statistically different than USC pts (median 13.0 and 48.5 mos.) (p = 0.841and 0.701 respectively). Pts who had no RD at the completion of their initial surgery (NACT 72.8%, USC 43.8%) had statistically improved OS and PFS compared to those with residual tumor. Stage IIIC NACT pts had significantly less postoperative hospital days (5.9 vs. 8.5), blood loss (487 vs. 909 cc) and transfusions (0.6 vs. 1.4) than USC pts. Stage IV NACT pts+ had significantly less hospital days (7.3 vs. 9.8) and blood loss at surgery (413 vs 689) than USC pts. Conclusions: NACT is an appropriate option for AS EOC pts who appear to be non-optimally SC with upfront surgery. No significant financial relationships to disclose.
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