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Impact of increased utilization of neoadjuvant chemotherapy on survival in patients with advanced ovarian cancer: experience from a comprehensive cancer center.

Authors
 Yong Jae Lee  ;  Young Shin Chung  ;  Jung-Yun Lee  ;  Eun Ji Nam  ;  Sang Wun Kim  ;  Sunghoon Kim  ;  Young Tae Kim 
Citation
 Journal of Gynecologic Oncology, Vol.29(4) : e63, 2018 
Journal Title
 Journal of Gynecologic Oncology 
ISSN
 2005-0380 
Issue Date
2018
Keywords
Chemotherapy, Adjuvant ; Debulking Surgical Procedure ; Neoadjuvant Therapy ; Ovarian Neoplasms
Abstract
OBJECTIVE: The choice between primary debulking surgery (PDS) and neoadjuvant chemotherapy (NAC) in advanced ovarian cancer remains controversial. We evaluated NAC use in our center before and after results from a randomized trial were published, with the aim to determine the impact of changes in the neoadjuvant strategy on survival in advanced-stage ovarian cancer. METHODS: We retrospectively investigated the clinical course of 435 patients with ovarian, tubal, or peritoneal carcinoma (International Federation of Gynecology and Obstetrics [FIGO] stage III or IV). According to the period of treatment, we stratified patients into a control group (n=216; diagnosed between 2006 and 2010; 83.8% underwent PDS) and a study group (n=219; diagnosed between 2011 and 2014; 48.9% received NAC followed by interval debulking surgery [IDS]). RESULTS: There were no between-group differences in age, body mass index, histology findings, or tumor grade. Compared to patients in the control group, those in the study group were more likely to receive NAC followed by IDS as first-line treatment (48.9% vs. 16.2%; p<0.001), cytoreductive surgery to no-residual disease (21.5% vs. 10.2%; p<0.001), or radical surgery (57.5% vs. 35.6%; p<0.001). However, there was no between-group difference in postoperative morbidity. Kaplan-Meier analysis showed no between-group differences in progression-free or overall survival (p=0.449 and 0.952, respectively). CONCLUSION: NAC incorporation resulted in increased optimal cytoreduction rates although no significant differences in survival outcomes were noted. NAC is advantageous for patients with high perioperative morbidity or unresectable disease.
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DOI
10.3802/jgo.2018.29.e63
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실)
Yonsei Authors
김상운(Kim, Sang Wun) ORCID logo https://orcid.org/0000-0002-8342-8701
김성훈(Kim, Sung Hoon) ORCID logo https://orcid.org/0000-0002-1645-7473
김영태(Kim, Young Tae) ORCID logo https://orcid.org/0000-0002-7347-1052
남은지(Nam, Eun Ji)
이용재(Lee, Yong Jae) ORCID logo https://orcid.org/0000-0003-0297-3116
이정윤(Lee, Jung-Yun)
정영신(Chung, Young Shin)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/165349
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