Comparison of Long-Term Survival Rates of Primary Surgery and Surgery After Neoadjuvant Chemotherapy in Ovarian Cancer
Journal Title: Istanbul Medical Journal - Year 2019, Vol 20, Issue 2
Abstract
Introduction: To compare long-term survival of primary debulking surgery (PDS) and interval debulking surgery (IDS) after neoadjuvant chemotherapy (NAC) in patients with advanced ovarian cancer. Methods: Patients who underwent debulking surgery for ovarian cancer between 2001 and 2014 were included in the study. Results: Of 378 patients, 191 (50.5%) underwent PDS and 187 (49.5%) underwent IDS. Compared with PDS group, IDS was associated with higher optimal surgical performance (residual <1 cm) (83% vs 65%, p<0.001), lower visible tumor rate in the upper abdomen during surgery (12% vs 46%, p<0.001), lower intraabdominal ascites rate (2% vs 64%, p<0.001), lower postoperative (within 30 days) mortality (0 vs 5) and lower bowel resection/colostomy rate (3% vs 11%, p=0.001). The median follow-up period was 43 (1-161) months. Overall survival (OS) was longer in the PDS group [56.8 months (95% CI: 48.2-65.4) vs 43.5 (95% CI: 38.1-48.8), log-rank test p=0.026]. PDS was superior in both residual subgroups, 64.9 vs 44.6 months (p=0.008) in ≤1 cm group and 41.6 vs 25.3 months (p=0.044) in >1 cm group. The 8-year OS was higher in the PDS group (31.8% vs 12.7%). According to multivariate Cox analysis, age, suboptimal debulking, IDS and presence of tumor in the upper abdomen were independent factors associated with shorter OS duration (hazard ratio: 1.013; 1.606; 1.456 and 1.495, respectively). Conclusion: NAC in patients with FIGO 2010 stage 3 ovarian cancers is useful in reducing tumor spread, surgical morbidity and suboptimal surgery rates. However, long-term survival rates were shorter than the PDS group.
Authors and Affiliations
Alpaslan Kaban, Samet Topuz, Hamdullah Sözen, Yavuz Salihoğlu
Keywords
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- EP ID EP549076
- DOI 10.4274/imj.galenos.2019.91297
- Views 209
- Downloads 0
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