Upfront cytoreductive surgery versus neoadjuvant chemotherapy in advanced epithelial ovarian cancer in Indian patients

Future Oncol. 2021 Sep;17(27):3607-3614. doi: 10.2217/fon-2021-0077. Epub 2021 Jul 15.

Abstract

In cases of ovarian carcinoma, primary cytoreductive surgery (CRS) is the standard treatment up to stage IIIB, but patient selection for neoadjuvant chemotherapy (NACT) in selected cases is controversial. A total of 200 patients with advanced ovarian cancer were analyzed retrospectively, according to specific selection criteria. Primary CRS was performed in 95 patients (47.5%) and interval CRS after 3-6 cycles of NACT was performed in 105 patients (52.5%). After median follow-up of 35 months, 5-year overall survival was 53.7% in the upfront CRS group and 42.2% in the NACT group. Primary CRS is the standard in advanced stages of ovarian carcinoma, but in certain subset of patients, NACT is preferred. Identifying that group is challenging but feasible. Proper selection of patients is key to successful outcomes.

Keywords: advanced carcinoma ovary; epithelial ovarian carcinoma; neoadjuvant chemotherapy (NACT); primary cytoreductive surgery (CRS); selection criteria.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Ovarian Epithelial / drug therapy*
  • Carcinoma, Ovarian Epithelial / pathology
  • Carcinoma, Ovarian Epithelial / surgery*
  • Cytoreduction Surgical Procedures*
  • Female
  • Humans
  • India
  • Middle Aged
  • Neoadjuvant Therapy*
  • Neoplasm Staging
  • Ovarian Neoplasms / drug therapy*
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / surgery*
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult