[Retrospective study: Late surgery post chemotherapy versus after 3-4 cures in treatment of advanced ovarian cancer]

Bull Cancer. 2020 Feb;107(2):157-170. doi: 10.1016/j.bulcan.2019.10.004. Epub 2019 Dec 16.
[Article in French]

Abstract

Introduction: Treatment in locally advanced ovarian cancer is optimal surgery followed by chemotherapy. Patients with significant tumor spread, OMS>2, age>75 years old are poor candidates for aggressive primary surgery. Interval surgery, after neo-adjuvant chemotherapy, aims to achieve more complete surgery, increase survival, and reduce surgical morbidity. The primary endpoint was progression-free survival. Secondary outcomes were overall survival and postoperative morbidity and mortality.

Method: This is a retrospective study conducted in 2 French referral centers between January 2000 and December 2015. Patients who could not benefit from a complete initial surgery were operated after 3 cures of chemotherapy at the François Baclesse center and after least 5 cures at the center René Gauducheau.

Results: The population analyzed included 104 patients, 43 (41.0%) patients treated at the René Gauducheau center (group 1) and 61 (59.0%) patients treated at the François Baclesse center (group 2). Progression-free and overall survival were similar between the 2 groups, they were, respectively, 15.9 months and 34 months in group 1 vs. 15.4 months and 37.6 months in group 2 (P=0.72; P=0.65). Mean hospital stay and postoperative morbidity were similar in both groups.

Conclusion: For weak patients, to limit invasive surgery, doing more than 5 courses of chemotherapy may be a reasonable option.

Keywords: Advanced ovarian cancer; Cancer de l’ovaire localement avancé; Chimiothérapie néoadjuvante; Chirurgie d’intervalle; Interval debulking surgery; Neoadjuvant chemotherapy; Nombre de cycles; Number of cycles.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / therapeutic use*
  • Chemotherapy, Adjuvant / methods
  • Female
  • France
  • Humans
  • Length of Stay
  • Middle Aged
  • Neoadjuvant Therapy / methods
  • Ovarian Neoplasms / drug therapy*
  • Ovarian Neoplasms / mortality
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / surgery*
  • Progression-Free Survival
  • Retrospective Studies

Substances

  • Antineoplastic Agents