Outcomes of Advanced Epithelial Ovarian Cancers Treated with Neoadjuvant Chemotherapy and Interval Debulking Surgery: An Audit from a Tertiary Care Referral Center in India

Abstract

Purpose

This institutional audit was conducted to analyze the surgical and survival outcomes in advanced epithelial ovarian cancers treated with neoadjuvant chemotherapy and interval debulking surgery.

Methods

Clinical records of patients of advanced epithelial ovarian cancers treated between January, 2011, and December, 2014, were retrospectively reviewed. Standard demographics, disease-related factors and treatment-related outcomes were analyzed.

Results

A total of 100 patients were included for analysis. A majority (97%) received paclitaxel and carboplatin in the neoadjuvant setting. The number of cycles of NACT did not affect the status of residual disease after IDS (P = 0.307). At a median follow-up of 69 months, the median PFS was 17.5 months (0–89) and median OS was 32 months (5–89). A chemotherapy response score of 3 was significantly associated with an improved PFS (P = 0.032*). No significant difference in PFS was noted with respect to the number of cycles of NACT; however, a trend was observed in favor of ≤ 3 cycles (P = 0.218). On subset analysis, patients with stage IIIC disease showed a trend towards better PFS with ≤ 3 cycles of NACT, though not statistically significant (P = 0.075). Also, no difference in PFS was noted if the total number of chemotherapy cycles was increased beyond 6 (P = 0.309).

Conclusions

The survival outcomes reported here are consistent with most results published in the literature. CRS is an important prognostic biomarker. Increasing the number of chemotherapy cycles beyond 6 does not affect survival. No definite conclusion could, however, be drawn with respect to the ideal number of NACT cycles and needs further evaluation.

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Correspondence to Bhavana Rai.

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Gupta, A., Kumar, D., Kaushal, V. et al. Outcomes of Advanced Epithelial Ovarian Cancers Treated with Neoadjuvant Chemotherapy and Interval Debulking Surgery: An Audit from a Tertiary Care Referral Center in India. Indian J Gynecol Oncolog 18, 38 (2020). https://doi.org/10.1007/s40944-020-00391-x

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Keywords

  • Epithelial ovarian cancers
  • Neoadjuvant chemotherapy
  • Interval debulking surgery