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Primary Cytoreductive Surgery Versus Interval Debulking Surgery Following Neoadjuvant Chemotherapy in Epithelial Ovarian Cancer: An Institutional Review

  • Zeeshanuddin AhmadEmail author
  • Amar Jain
  • Nikhil Mehta
  • Elroy Saldanha
  • Dhruv Patel
  • Sanjay M. Desai
Original Article
  • 3 Downloads

Abstract

Objective

To compare the overall survival of women with advanced-stage EOC treated by PCS versus NACT followed by IDS.

Design, Setting, and Participants

Retrospective study of women with stage IIB–IVA ovarian carcinoma FIGO staging diagnosed between 2016 and 2018 treated at Department of Surgical Oncology, Sri Aurobindo Medical College and Post Graduate Institute, Indore.

Exposures

Initial treatment approach of PCS versus NACT + IDS, examined using an intent-to-treat analysis.

Results

The median follow-up was 18 months (10–36 months) in both groups. The median overall survival was 38 months in PCS group and 31 months in NACT group. Postoperative complications were seen more often in PCS group (11.3%) against 3.33% in NACT group. Patients with residual disease (microscopic and macroscopic residual disease) had poorer prognosis.

Conclusions

Primary cytoreductive surgery is associated with improved survival compared with NACT in otherwise healthy women with bulky epithelial ovarian. The biggest risk associated with the use of NACT is that patients with significant side effects and refractory disease will lose the opportunity for initial surgery. The lower survival in women receiving NACT can be owed to limited performance status in women undergoing NACT.

Keywords

Epithelial ovarian cancer (EOC) Primary cytoreductive surgery (PCS) Interval debulking surgery (IDS) Neoadjuvant chemotherapy (NACT) 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors have no potential conflict of interest to disclose.

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Copyright information

© Association of Gynecologic Oncologists of India 2019

Authors and Affiliations

  • Zeeshanuddin Ahmad
    • 1
    Email author
  • Amar Jain
    • 1
  • Nikhil Mehta
    • 1
  • Elroy Saldanha
    • 1
  • Dhruv Patel
    • 1
  • Sanjay M. Desai
    • 1
  1. 1.Department of Surgical OncologySri Aurobindo Medical College and Post Graduate InstituteIndoreIndia

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