To compare the optimal cytoreduction rate in advanced epithelial ovarian cancer stage III/IV after 3 versus 6 cycles of neoadjuvant chemotherapy

• Published in: Journal of obstetrics and gynaecology Vol. 41; no. 4; p. 616
• Main Authors: Kumari, Archana, Thakur, Monika, Saha, S C, Suri, Vanita, Prasad, G R V, Patel, Firuza D, Radhika, S
• Format: Journal Article
• Language: English
• Published: England 19.05.2021
• Subjects: Adult; Carcinoma, Ovarian Epithelial - pathology; Carcinoma, Ovarian Epithelial - therapy; Cytoreduction Surgical Procedures - statistics & numerical data; Female; Humans; Middle Aged; Neoadjuvant Therapy - methods; Neoplasm Staging; Ovarian Neoplasms - pathology; Ovarian Neoplasms - therapy; Pilot Projects; Prospective Studies; Treatment Outcome; neoadjuvant chemotherapy; advanced epithelial ovarian cancer; late IDS; Interval debulking surgery; early IDS
• ISSN: 1364-6893
• DOI: 10.1080/01443615.2020.1787967

This study aimed to compare the impact of 3 versus 6 cycles of neoadjuvant chemotherapy (NACT) on the optimal cytoreduction in patients of advanced ovarian malignancy during interval debulking surgery (IDS). Thirty patients with advanced-stage IIIc/IV epithelial ovarian cancer, fallopian tube cancer, and primary peritoneal cancer were randomly allocated to receive 6 cycles in the late IDS group versus 3 cycles in early IDS before undergoing interval debulking surgery. A higher percentage of patients achieved optimal cytoreduction in the late IDS group compared to the early IDS group (60 versus 23%) which was statistically significant ( = .010). Giving 6 cycles of NACT before surgery increased the odd of optimal cytoreduction by 10 than giving 3 cycles of NACT which was statistically significant (  = 0.046) Thus, we conclude that administering 6 cycles of neoadjuvant chemotherapy before debulking surgery helps in achieving optimal cytoreduction in a higher number of patients with lesser surgical morbidity.IMPACT STATEMENT Currently, there are no established criteria that would help to determine the number of chemotherapy cycles before debulking surgery in patients with advanced ovarian malignancy. Administering 6 cycles of neoadjuvant chemotherapy before debulking surgery helps in achieving optimal cytoreduction in a higher number of patients with lesser surgical morbidity in cases of advanced epithelial ovarian cancer. We conclude that late interval debulking may be used as a treatment option in the advanced stage IIIc/stage IV. However, the findings need to be studied in a larger study group with a longer follow up period.