| Yinghui Li,Shaojia Wang,Linlin Yang,Chunmei Yin,Hongying Yang. A retrospective clinical study of neoadjuvant chemotherapy for advanced epithelial ovarian cancer. Oncol Transl Med, 2017, 3: 231-240. |
| A retrospective clinical study of neoadjuvant chemotherapy for advanced epithelial ovarian cancer |
| Received:October 09, 2017 Revised:November 15, 2017 |
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| KeyWord:neoadjuvant chemotherapy (NACT); advanced epithelial ovarian cancer (EOC); cytoreduction surgery; prognostic factors |
| Author Name | Affiliation | E-mail | | Yinghui Li | Yunnan Cancer Hospital & The Third Affiliated Hospital of Kunming Medical University & Yunnan Cancer Center, Kunming 650000, China | 742919339@qq.com | | Shaojia Wang | Yunnan Cancer Hospital DdDd The Third Affiliated Hospital of Kunming Medical University DdDd Yunnan Cancer Center, Kunming 650000, China | | | Linlin Yang | Yunnan Cancer Hospital DdDd The Third Affiliated Hospital of Kunming Medical University DdDd Yunnan Cancer Center, Kunming 650000, China | | | Chunmei Yin | Yunnan Cancer Hospital DdDd The Third Affiliated Hospital of Kunming Medical University DdDd Yunnan Cancer Center, Kunming 650000, China | | | Hongying Yang | Yunnan Cancer Hospital DdDd The Third Affiliated Hospital of Kunming Medical University DdDd Yunnan Cancer Center, Kunming 650000, China | jyahy@tom.com |
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| Abstract: |
| Objective The aim of this study was to investigate the clinical efficacy of neoadjuvant chemotherapy
(NACT) and the prognostic factors for advanced epithelial ovarian cancer (EOC).
Methods We enrolled 241 patients with stage III and IV EOC who were diagnosed at the Yunnan
Cancer Hospital between October 2006 and December 2015. The observation (NACT-IDS) group (n =
119) received 1–3 courses of platinum-based NACT, followed by interval debulking surgery (IDS) and 6–8
courses of postoperative chemotherapy. The control group underwent primary debulking surgery (PDS) (n
= 122) followed by 6–8 courses of postoperative chemotherapy. We analyzed the general conditions of the
operations and the survival of both groups.
Results Operating time, intraoperative blood loss and postoperative hospitalization were significantly
lower in the NACT-IDS group (P < 0.05). The rate of optimal cytoreductive surgery was significantly higher
in the NACT-IDS group (P < 0.05). A visible residual lesion was observed in 49 (41.18%) and 48 (40%)
cases in the NACT-IDS and PDS groups, respectively, which were not significantly different (P > 0.05).
The percentage of International Federation of Gynecology and Obstetrics (FIGO) stage IV tumors and
the recurrence rates were significantly higher in the NACT-IDS group (P < 0.05). The mortality rates
were 45.19% (47/104) and 35.19% (38/108) in the NACT-IDS and PDS groups, respectively (P > 0.05).
Progression-free survival was 23.75 ± 9.98 and 23.57 ± 12.25 months in the NACT-IDS and PDS groups,
respectively (P > 0.05). Overall survival (OS) was 31.11 ± 15.66 and 29.63 ± 18.00 months in the NACTIDS
and PDS groups, respectively (P > 0.05). Optimal cytoreductive surgery with or without residual lesion
was an independent influencing factor for advanced EOC in multivariate analysis. OS of patients treated
with ≥8 courses of chemotherapy was significantly longer than those treated with < 8 courses.
Conclusion NACT could improve the intra- and postoperative conditions in advanced EOC patients.
Although the percentage of FIGO stage IV cancer was significantly higher in the NACT-IDS group, the
prognosis was similar in both the NACT-IDS and PDS groups, suggesting that NACT improves the clinical
outcome of advanced EOC. Optimal cytoreductive surgery with no residual lesion is a long-term protective
factor in advanced EOC. At least 8 courses of chemotherapy overall or ≥ 6 courses postoperatively
improves the OS. |
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