Achieving Complete Radiological and Bio-Chemical Response as a Predictor of Long-Term Survival in Stage IV Epithelial Ovarian Cancer

• Published in: Curēus (Palo Alto, CA) Vol. 13; no. 11; p. e20017
• Main Authors: Sarwar, Hafiz Abubakar, Iftikhar, Jhanzeb, Azhar, Musa, Munawar, Kiran, Hanif, Muhammad Rashid, Abu Bakar, Muhammad, Siddiqui, Neelam
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 29.11.2021; Cureus
• Subjects: Activities of daily living; Age; Ascites; Body mass index; Breast cancer; Histopathology; Induction therapy; Lymphatic system; Medical prognosis; Metastasis; Mutation; Obstetrics/Gynecology; Oncology; Ovarian cancer; Patients; Pleural effusion; Standard deviation; Statistical analysis; Tumors; Womens health; United States > US; Lahore Pakistan; Pakistan; epithelial ovarian cancer; hereditary breast and ovarian cancer; ovarian cancer; metastatic ovarian cancer; interval debulking surgery
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.20017

Objective Epithelial ovarian cancer (EOC) is common among ovarian cancers. The majority of existing literature shows combined data of stage III and stage IV. Therefore, we aimed to look for whether achieving complete radiological and biochemical response after initial treatment of stage IV epithelial ovarian cancer as a predictor of long-term survival in the Pakistani population. Methods A cross-sectional study was conducted of patients with stage IV epithelial ovarian cancer diagnosed and treated from 2006-2013 at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan. Overall survival was defined as the number of months between patients' diagnosis at the hospital and any cause of death or last follow-up date. Kaplan Meier curve was used to report the overall survival. The log-rank test was used to distinguish the survival difference in complete and no complete response. P-value <0.05 was considered statistically significant. Result A total of fifty patients of stage IV epithelial ovarian carcinoma, with a mean age of 53 ± 2 received neoadjuvant chemotherapy and suitable patients underwent interval-debulking surgery. Among these fifty patients, twenty-one (42%) patients who achieved complete radiological and biochemical response had a median survival of greater than five years. Patients without co-morbidities (46%) and having good performance status (52%) showed better results of the treatment. Patients' tolerance to chemotherapy with good response and fit enough to undergo interval-debulking surgery, achieving complete radiological and biochemical response after initial induction therapy were significantly associated with long-term survival (P<0.05). Conclusion Outcomes of patients who present with stage IV EOC remains dismal. Patients who achieved complete radiological and biochemical response after neoadjuvant chemotherapy and interval-debulking surgery was significantly associated with long-term survival.