Abstract
To analyze efficacy of neoadjuvant chemotherapy for advanced ovarian cancer. A total of 107 patients with advanced ovarian cancer undergoing cytoreductive surgery were divided into a neoadjuvant chemotherapy group (n=61) and a primary debulking group (n=46) and retrospectively analyzed. Platinum-based adjuvant chemotherapy was applied to both groups after cytoreductive surgery ande overall and progression-free survival times were calculated. No significant difference was observed in duration of hospitalization (20.8±6.1 vs. 20.2±5.4 days, p>0.05). The operation time of neoadjuvant chemotherapy group was shorter than the initial surgery group (3.1±0.7 vs. 3.4±0.8 h, p<0.05). There were no significant differences in median overall survival time between neoadjuvant chemotherapy group and surgery group (42 vs. 55 months, p>0.05). Similarly, there was no difference in median progression-free survival between neoadjuvant chemotherapy group and surgery group (16 vs. 17 months, p>0.05). The surgical residual tumor size demonstrated no significant difference between initial surgery and neoadjuvant chemotherapy groups (p>0.05). Multivariate analysis showed that more than 3 cycles of regimen with neoadjuvant chemotherapy was associated with more resistance to chemotherapy compared with patients without receiving neoadjuvant chemotherapy (OR: 5.962, 95%CI: 1.184-30.030, p<0.05). Neoadjuvant chemotherapy can shorten the operation time. However, it does not improve survival rates of advanced ovarian cancer patients.
Highlights
Ovarian cancer is a common form of cancer in women and the main cause of death among all gynecologic cancers
Neoadjuvant chemotherapy represents a few cycles of chemotherapy given prior to tumor cytoreductive surgery which especially suitable for patients with advanced ovarian cancer
Neoadjuvant chemotherapy has the following advantages: i) neoadjuvant chemotherapy drug administration through thoracic and abdominal cavity can control the ascites, improve the general condition so as to improve the operation tolerance; ii) Destroy the liver, lung metastasis, reduce tumor staging, increase the operation feasibility; iii) Reduce tumor volume, loose tumor and normal tissue adhesions, reduce operation risk; reduction of abdominal tumor metastasis, shorten operation time, reduce intraoperative bleeding, effectively improve the cytoreductive surgery success rate; iv) obtain the operation resection specimens to evaluated the chemotherapy sensitivity; v) The neoadjuvant chemotherapy is especially suitable for advanced cancer patients with generally poor quality, large metastasis tumor, high serum CA125 level or tumor difficult to clean (Le et al, 2007; Akita et al, 2009)
Summary
Ovarian cancer is a common form of cancer in women and the main cause of death among all gynecologic cancers. Primary cytoreductive surgery followed by chemotherapy represents the current standard treatment for patients with advanced ovarian cancer (McGuire et al, 1996; Monk et al, 2013). For patients with poor general condition or not satisfied with tumor resection, several cycles of chemotherapy before surgery was used. Neoadjuvant chemotherapy followed by interval debulking surgery has been proposed as an alternative approach for the initial management of ovarian cancer, aiming at the improvement of surgical efficiency and patients’ quality of life. In a retrospective study by Mazzeo et al (2003), patients with primarily unresectable ovarian cancer received a median of four platinum-based neoadjuvant chemotherapy courses, followed by surgery and adjuvant chemotherapy in patients with an objective response or stable disease after induction of chemotherapy. Complete resection of all macroscopic disease (at primary or interval surgery) was the strongest independent variable in predicting overall survival
Sign-in/Register to view highlights & summary 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 callMore From: Asian Pacific journal of cancer prevention : APJCP
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
