Outcome of Epithelial Ovarian Cancer: Time for Strategy Trials to Resolve the Problem of Optimal Timing of Surgery. Issue 6 (1st July 2015)

• Record Type: Journal Article
• Authors: Van de Putte, Gregg; Oben, Jolien; Prenen, Leen; Schobbens, Jean Christophe; Vlasselaer, Jos; Van Holsbeke, Caroline; Debrock, Guy; Van Eycken, Peter; de Jonge, Eric
• Is Part Of: International journal of gynecological cancer. Volume 25:Issue 6(2015:Jul.)
• Page Start: 993
• Page End: 999
• Publication Date: 2015-07-01
• Subjects: Ovarian carcinoma -- Surgery -- Neoadjuvant chemotherapy -- Survival -- Strategy; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1097/IGC.0000000000000461
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Introduction: The standard treatment of ovarian cancer is the combination of debulking surgery and chemotherapy. There is an ongoing discussion on which treatment is best: primary debulking surgery (PDS) or neoadjuvant chemotherapy with interval debulking (NACT-IDS). Even a large randomized trial has not settled this issue. We examined whether comparing a specified treatment protocol would not be a more logical approach to answer this type of discussions. Methods: A retrospective study of 142 consecutively treated patients according to a fixed protocol between 2000 and 2012 was conducted. Disease-free survival and overall survival were calculated by univariate and multivariate analyses for the whole group and for advanced stages separately. Specific differences between PDS and NACT-IDS were studied. Comparison of results from large databases was made. Results: Disease-free survival and overall 5-year survival for the whole group were 35% and 50%. For the advanced stages, disease-free survival and overall 5-year survival were 14% and 36%, with a median disease-free and overall survival of 16 and 44 months. Of the 98 women with advanced ovarian carcinoma, 54% of operable patients underwent PDS and 44% underwent NACT-IDS. More patients in the PDS group were optimally (<1 cm) debulked: 80% vs 71%. There was no significant difference in survival between PDS or NACT-IDS. Optimally debulked patients had a significant better overall survival in multivariate analysis with a hazard ratio of 2.1. Discussion: Outcome of treatment according to a fixed protocol with a mixture of PDS and NACT-IDS was similar to results from large databases. We hypothesize that comparison of a specific strategy may yield more useful results than awaiting the perfect randomized trial.