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Joyce F. Liu, MD, MPH
Joyce F. Liu, MD, MPH
Posted: Tuesday, March 30, 2021
Women with advanced-stage epithelial ovarian cancer who underwent primary cytoreductive surgery had better 10-year overall survival outcomes than those who were given neoadjuvant chemotherapy, according to retrospective research conducted by Taymaa May, MD, MSc, FRCSC, of Princess Margaret Cancer Centre, Toronto, Ontario, Canada, and colleagues. These findings, which are based on a cohort study of 326 patients and published in the International Journal of Gynecology & Obstetrics, suggest that neoadjuvant chemotherapy should be used solely for patients who are not able to undergo optimal primary cytoreductive surgery.
Between 2001 and 2001, patients either underwent primary cytoreductive surgery followed by adjuvant systemic chemotherapy or received neoadjuvant chemotherapy and then had interval cytoreductive surgery. The researchers collected data on cancer recurrence, vital status, cause of death, and date of death.
Findings revealed that for patients with stage IIIC or IV ovarian cancer who underwent primary cytoreductive surgery, the 10-year survival rate was 19.3%, compared with 9.1% for those who had neoadjuvant chemotherapy (P < .001). The 10-year survival rate was 36% for patients with 0 mm of residual disease after primary cytoreductive surgery, compared with 10.5% for patients with 1 to 9 mm of residual disease and 5.0% for patients with at least 10 mm of residual disease (P < .001). The association between residual disease and 10-year survival rate for patients who received neoadjuvant chemotherapy was not found to be statistically significant (P = .080).
The investigators acknowledged that their study had several limitations. First, it was not a randomized trial, and all causes of survival difference were not known. Second, there was no information about exactly why neoadjuvant chemotherapy was chosen for patients. Third, the researchers were not able to account for selection bias due to tumor load or patient comorbidities.
Disclosure: The study authors reported no conflicts of interest.
International Journal of Gynecology & Obstetrics
