Does neoadjuvant chemotherapy impair long-term survival for ovarian cancer patients? A nationwide Danish study

Fagö-Olsen, Carsten Lindberg; Ottesen, Bent; Kehlet, Henrik; Antonsen, Sofie Leisby; Christensen, Ib Jarle; Markauskas, Algirdas; Mosgaard, Berit Jul; Ottosen, Christian; Soegaard, Charlotte H; Soegaard-Andersen, E; Høgdall, Claus

doi:10.1016/j.ygyno.2013.11.035

Cited by 62 publications

(71 citation statements)

References 32 publications

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“…Out of the 12 studies, 5 studies were arranged with a total of 6 chemotherapeutic cycles [1, 4, 5, 23, 25], including 1,606 patients, with 705 for NAC and 901 for PDS. The characteristics of trials included in this systematic review and meta-analysis are summarized in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 5 of the 12 studies provided the information on postoperative adverse reactions [1, 4, 23-25]. All of them were graded according to the Memorial Sloan-Kettering Cancer Center Surgical Secondary Events Grading System.…”

Section: Resultsmentioning

confidence: 99%

“…Originally, NAC followed by an IDS was limited to patients who were poor surgical candidates or unlikely to be resected optimally [7, 9-12, 14-22, 25-29, 31-40]. However, the EORTC/NCIC trial showed the similar median OS (30.0 vs. 29.0 months) and median PFS (12 vs. 12 months) between the NAC group and PDS group, concluding that NAC followed by IDS was a reasonable treatment for advanced ovarian carcinoma.…”

Section: Discussionmentioning

confidence: 99%

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Platinum-Based Neoadjuvant Chemotherapy versus Primary Surgery in Ovarian Carcinoma International Federation of Gynecology and Obstetrics Stages IIIc and IV: A Systematic Review and Meta-Analysis

Yunyun

Xie

Wang

et al. 2017

Gynecol Obstet Invest

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Background/Aim: This study aimed to compare neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS) with primary debulking surgery (PDS) followed by chemotherapy in patients with advanced ovarian carcinoma International Federation of Gynecology and Obstetrics (FIGO) stages IIIc and IV. Methods: PubMed, the Cochrane Library, and manual searches were applied to discriminate potentially eligible studies published before June 30, 2016. Results: A total of 12 comparative studies were finally included; 1,372 patients underwent NAC followed by IDS, and 2,680 patients underwent PDS followed by chemotherapy. For overall pooled estimates, significant between-trial differences were found in the optimal debulking rate, grade 3–5 postoperative adverse reactions, and median overall survival (OS), but no difference was found in the median progression-free survival (PFS). Moreover, a significantly higher incidence was identified in major infections, vascular events, and wound complications for patients in the PDS group. Conclusions: This study suggested that NAC followed by IDS could improve the optimal debulking rate and decrease the postoperative adverse reactions for the current studies, but whether it could improve the OS and PFS compared with PDS followed by chemotherapy in patients with ovarian carcinoma FIGO stages IIIc and IV were still needed to be verified by conducting more randomized controlled trials.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Platinum-Based Neoadjuvant Chemotherapy versus Primary Surgery in Ovarian Carcinoma International Federation of Gynecology and Obstetrics Stages IIIc and IV: A Systematic Review and Meta-Analysis

Yunyun

Xie

Wang

et al. 2017

Gynecol Obstet Invest

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“…As a result, the debate on the role of PDS and IDS has been reopened, based on the difficulty of achieving an RT "equal to zero" in primary cytoreductive surgery and the morbi-mortality associated to it. For this reason, several studies in favor of PDS and IDS have been published, taking into account the fact that the rates of RT = 0 can vary widely in literature, anywhere from 15 to 85% depending on the center, hence the ongoing debate [14,15,[24][25][26][27][28][29][30][31][32][33].…”

Section: Discussionmentioning

confidence: 99%

“…In a recent study, Fagö-Olsen et al [14] compared the OS and PFS of patients with advanced EOC based on whether they underwent PDS or IDS, with no prior laparoscopy. The RT = 0 results were 39% for the first group and 52% for the second, with an OS of 55.5 months and 36.7 months, respectively, with p = 0.002.…”

Section: Discussionmentioning

confidence: 99%

Impact of Laparoscopy to Assess Resectability in Stage IIIC Epithelial Ovarian, Tubal and Peritoneal Cancer Patients

Sánchez-Iglesias

Pérez-Benavente

Correa-Paris

et al. 2018

Gynecol Obstet Invest

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Aims: To evaluate overall survival (OS) and progression-free survival (PFS) in patients with stage IIIC epithelial ovarian, tubal and peritoneal cancer (EOC) who underwent a laparoscopy to assess surgical resectability prior to Primary Debulking Surgery (PDS) or Interval Debulking Surgery (IDS). Methods: Retrospective cohort study that included all women with stage IIIC EOC treated at our center between 2000 and 2010. Patients were classified in groups: PDS, neoadjuvant chemotherapy (NACT) with IDS, NACT without IDS; and then sub-classified based on residual tumor (RT). A laparoscopy to assess resectability was performed before PDS and IDS. Results: Among 111 patients included, 66 underwent PDS, and 45 were treated with NACT, 80% of them receiving subsequent IDS. OS was 75.6 months in the PDS group, and 52.8 months for IDS group (p = 0.100); the PFS was 30 months and 19.2 months respectively (p = 0.049). Median OS was 104.4 and 52.8 months for patients with optimal cytoreduction (RT = 0) in the PDS and IDS group respectively (p < 0.05). Laparoscopy did not modify the preoperative consideration for PDS; however, 9 laparotomies were avoided based on laparoscopic findings after NACT. Conclusion: Laparoscopy for the assessment of surgical resectability in stage IIIC EOC has no impact on survival; but it still could be useful for the reduction of unnecessary laparotomies after NACT.

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The prognostic effect of residual tumor for advanced epithelial ovarian cancer treated with neoadjuvant chemotherapy or primary debulking surgery

Yang

Chen

et al. 2022

Cancer Medicine

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Does neoadjuvant chemotherapy impair long-term survival for ovarian cancer patients? A nationwide Danish study

Cited by 62 publications

References 32 publications

Platinum-Based Neoadjuvant Chemotherapy versus Primary Surgery in Ovarian Carcinoma International Federation of Gynecology and Obstetrics Stages IIIc and IV: A Systematic Review and Meta-Analysis

Platinum-Based Neoadjuvant Chemotherapy versus Primary Surgery in Ovarian Carcinoma International Federation of Gynecology and Obstetrics Stages IIIc and IV: A Systematic Review and Meta-Analysis

Impact of Laparoscopy to Assess Resectability in Stage IIIC Epithelial Ovarian, Tubal and Peritoneal Cancer Patients

The prognostic effect of residual tumor for advanced epithelial ovarian cancer treated with neoadjuvant chemotherapy or primary debulking surgery

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