Neoadjuvant chemotherapy followed by interval debulking surgery versus primary debulking surgery in the advanced epithelial ovarian cancer- a retrospective cohort study

Background/Aim. The gold standard in treating the advanced ovarian cancer (AOC) is primary debulking surgery (PDS) followed by platinum-based adjuvant chemotherapy. In the AOC, the extent of tumor resection (residual tumor volume) is the most important prognostic factor for overall survival (OS) and...

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Main Authors: Maričić Slobodan, Mandić Aljoša, Dejanović Ninoslav, Kladar Nebojša, Popović Marina, Ivković-Kapicl Tatjana, Gutić Bojana, Kokanov Dunja
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2021-01-01
Series:Vojnosanitetski Pregled
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Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2021/0042-84502000038M.pdf
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author Maričić Slobodan
Mandić Aljoša
Dejanović Ninoslav
Kladar Nebojša
Popović Marina
Ivković-Kapicl Tatjana
Gutić Bojana
Kokanov Dunja
author_facet Maričić Slobodan
Mandić Aljoša
Dejanović Ninoslav
Kladar Nebojša
Popović Marina
Ivković-Kapicl Tatjana
Gutić Bojana
Kokanov Dunja
author_sort Maričić Slobodan
collection DOAJ
description Background/Aim. The gold standard in treating the advanced ovarian cancer (AOC) is primary debulking surgery (PDS) followed by platinum-based adjuvant chemotherapy. In the AOC, the extent of tumor resection (residual tumor volume) is the most important prognostic factor for overall survival (OS) and progression-free survival (PFS). Neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) is an experimental treatment of the AOC, introduced in clinical practice in order to improve cytoreduction rate and prolong survival. The aim of this study was to compare the survival and cytoreduction rate of NACT+IDS and PDS in patients with the AOC. Methods. This retrospective cohort study included patients with the AOC, separated into two groups. The first group treated with PDS had 59 patients, while the second group, treated with NACT + IDS, had 33 patients. Results. A lower rate of suboptimal cytoreduction (39.39%) was found in the NACT + IDS group than in the PDS group (57.63%). The percentage of complete cytoreduction was higher in patients treated with NACT + IDS (51.52%) than in those treated with PDS (38.98%). Nevertheless, median OS and PFS were not significantly different between the groups (p < 0.05). OS was 35 months and 31 months in the PDS and NACT + IDS groups, respectively. PFS was 16 months in the PDS and 19 months in the NACT + IDS group. Conclusion. Despite the higher rate of optimal debulking surgery after NACT+ IDS, survival of patients treated with method was not better than those treated with PDS. The decision for either NACT+IDS or PDS should be tailored to the individual patient.
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spelling doaj-art-11a657e983c649b6b6b85e9fd0780bdc2025-08-20T03:17:09ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202021-01-0178111193119910.2298/VSP190110038M0042-84502000038MNeoadjuvant chemotherapy followed by interval debulking surgery versus primary debulking surgery in the advanced epithelial ovarian cancer- a retrospective cohort studyMaričić Slobodan0Mandić Aljoša1https://orcid.org/0000-0002-6719-8694Dejanović Ninoslav2Kladar Nebojša3Popović Marina4Ivković-Kapicl Tatjana5Gutić Bojana6Kokanov Dunja7University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + Oncology Institute of Vojvodina, Sremska Kamenica, SerbiaUniversity of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + Oncology Institute of Vojvodina, Sremska Kamenica, SerbiaOncology Institute of Vojvodina, Sremska Kamenica, SerbiaUniversity of Novi Sad, Faculty of Medicine, Novi Sad, Serbia Oncology Institute of Vojvodina, Sremska Kamenica, SerbiaUniversity of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + Oncology Institute of Vojvodina, Sremska Kamenica, SerbiaUniversity of Novi Sad, Faculty of Medicine, Novi Sad, Serbia + Oncology Institute of Vojvodina, Sremska Kamenica, SerbiaOncology Institute of Vojvodina, Sremska Kamenica, SerbiaBackground/Aim. The gold standard in treating the advanced ovarian cancer (AOC) is primary debulking surgery (PDS) followed by platinum-based adjuvant chemotherapy. In the AOC, the extent of tumor resection (residual tumor volume) is the most important prognostic factor for overall survival (OS) and progression-free survival (PFS). Neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) is an experimental treatment of the AOC, introduced in clinical practice in order to improve cytoreduction rate and prolong survival. The aim of this study was to compare the survival and cytoreduction rate of NACT+IDS and PDS in patients with the AOC. Methods. This retrospective cohort study included patients with the AOC, separated into two groups. The first group treated with PDS had 59 patients, while the second group, treated with NACT + IDS, had 33 patients. Results. A lower rate of suboptimal cytoreduction (39.39%) was found in the NACT + IDS group than in the PDS group (57.63%). The percentage of complete cytoreduction was higher in patients treated with NACT + IDS (51.52%) than in those treated with PDS (38.98%). Nevertheless, median OS and PFS were not significantly different between the groups (p < 0.05). OS was 35 months and 31 months in the PDS and NACT + IDS groups, respectively. PFS was 16 months in the PDS and 19 months in the NACT + IDS group. Conclusion. Despite the higher rate of optimal debulking surgery after NACT+ IDS, survival of patients treated with method was not better than those treated with PDS. The decision for either NACT+IDS or PDS should be tailored to the individual patient.http://www.doiserbia.nb.rs/img/doi/0042-8450/2021/0042-84502000038M.pdfcytoreduction surgical proceduresdrug therapygynecologic surgical proceduresovarian neoplasmssurvivalprognosis
spellingShingle Maričić Slobodan
Mandić Aljoša
Dejanović Ninoslav
Kladar Nebojša
Popović Marina
Ivković-Kapicl Tatjana
Gutić Bojana
Kokanov Dunja
Neoadjuvant chemotherapy followed by interval debulking surgery versus primary debulking surgery in the advanced epithelial ovarian cancer- a retrospective cohort study
Vojnosanitetski Pregled
cytoreduction surgical procedures
drug therapy
gynecologic surgical procedures
ovarian neoplasms
survival
prognosis
title Neoadjuvant chemotherapy followed by interval debulking surgery versus primary debulking surgery in the advanced epithelial ovarian cancer- a retrospective cohort study
title_full Neoadjuvant chemotherapy followed by interval debulking surgery versus primary debulking surgery in the advanced epithelial ovarian cancer- a retrospective cohort study
title_fullStr Neoadjuvant chemotherapy followed by interval debulking surgery versus primary debulking surgery in the advanced epithelial ovarian cancer- a retrospective cohort study
title_full_unstemmed Neoadjuvant chemotherapy followed by interval debulking surgery versus primary debulking surgery in the advanced epithelial ovarian cancer- a retrospective cohort study
title_short Neoadjuvant chemotherapy followed by interval debulking surgery versus primary debulking surgery in the advanced epithelial ovarian cancer- a retrospective cohort study
title_sort neoadjuvant chemotherapy followed by interval debulking surgery versus primary debulking surgery in the advanced epithelial ovarian cancer a retrospective cohort study
topic cytoreduction surgical procedures
drug therapy
gynecologic surgical procedures
ovarian neoplasms
survival
prognosis
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2021/0042-84502000038M.pdf
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