Upfront debulking surgery or delayed surgery after neoadjuvant chemotherapy for advanced-stage epithelial ovarian cancer: Comparison of survival from a noncancer center in India
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Date
2024-03
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Publisher
Medknow Publications
Abstract
Background: In advanced?stage epithelial ovarian cancer (EOC) standard of care is upfront debulking surgery (UDS) followed by adjuvant chemotherapy. Interval debulking surgery after neoadjuvant chemotherapy (NACT?IDS) is a reasonable alternative. Methods: This study was a retrospective review of patients of Stage III/IV EOC treated either by UDS or NACT?IDS between January 2016 and December 2018 to report the comparison of progression?free survival (PFS) and overall survival (OS) of patients with advanced?stage EOC treated with either UDS or NACT?IDS. Results: Out of 50 patients, 19 (38%) underwent UDS, and 31 (62%) received NACT. The mean follow?up duration was 27.7 months. No gross residual disease was achieved in 52.6% of the UDS group and in 70.4% of the NACT?IDS group. The median PFS of 20 and 30 months was observed in the UDS and NACT?IDS groups, respectively (log?rank P = 0.054). The median OS was 36 months in the NACT?IDS group and could not be reached in the UDS group (log?rank P = 0.329). Only residual disease was significantly associated with survival (hazards ratio 3.03, 95% confidence interval: 1.19�74) on multivariate Cox regression analysis. Conclusions: In advanced?stage EOC, the survival outcomes of NACT?IDS are comparable with those of UDS. Apart from the patient?specific parameters, the decision for UDS or NACT?IDS should take in account the expertise of the surgeon and the institutional capacity as a whole.
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Keywords
Cancer survival, epithelial ovarian cancer, neoadjuvant chemotherapy, upfront debulking surgery
Citation
Shekhar S, Singh P, Vishnoi JR, Goel S, Pareek P, Sharma C, Goyal M, Yadav G, Jhirwal M, Soni S, Misra S. Upfront debulking surgery or delayed surgery after neoadjuvant chemotherapy for advanced-stage epithelial ovarian cancer: Comparison of survival from a noncancer center in India. International Journal of Medical Research & Health Sciences. 2024 Mar; 61(1): 68-74