OBJECTIVE: This study aims to determine whether neoadjuvant chemotherapy (NAC) has survival benefit in selected patients with advanced epithelial ovarian cancer (EOC) who have high risk of suboptimal cytoreduction which is represented by high serum CA-125 level. METHODS: We retrospectively reviewed records of 314 patients with EOC including 94 patients who received NAC. After stratification by preoperative CA-125 levels, the progression-free survival (PFS) was compared between the NAC group and the primary debulking surgery (PDS) group. RESULTS: The NAC group had more FIGO stage IV disease (P<0.001) and higher CA-125 levels (P<0.001). Although suboptimal resection rate was higher in the PDS group (50% vs. 18%, P<0.001), however, NAC was not associated with increased PFS in multivariate Cox analysis (P=0.334). Nevertheless, after stratification according to CA-125 levels, NAC showed survival benefit in the subgroup with high CA-125 levels (>2000 U/ml; HR 0.62, P=0.037). CONCLUSION: Our preliminary data suggests the possible interaction between CA-125 levels and survival benefit of NAC. The randomized trial data about NAC should be stratified by the reproducible and relevant criteria such as preoperative serum CA-125 level to elucidate true survival benefit of NAC in ovarian cancer.
OBJECTIVE: This study aims to determine whether neoadjuvant chemotherapy (NAC) has survival benefit in selected patients with advanced epithelial ovarian cancer (EOC) who have high risk of suboptimal cytoreduction which is represented by high serum CA-125 level. METHODS: We retrospectively reviewed records of 314 patients with EOC including 94 patients who received NAC. After stratification by preoperative CA-125 levels, the progression-free survival (PFS) was compared between the NAC group and the primary debulking surgery (PDS) group. RESULTS: The NAC group had more FIGO stage IV disease (P<0.001) and higher CA-125 levels (P<0.001). Although suboptimal resection rate was higher in the PDS group (50% vs. 18%, P<0.001), however, NAC was not associated with increased PFS in multivariate Cox analysis (P=0.334). Nevertheless, after stratification according to CA-125 levels, NAC showed survival benefit in the subgroup with high CA-125 levels (>2000 U/ml; HR 0.62, P=0.037). CONCLUSION: Our preliminary data suggests the possible interaction between CA-125 levels and survival benefit of NAC. The randomized trial data about NAC should be stratified by the reproducible and relevant criteria such as preoperative serum CA-125 level to elucidate true survival benefit of NAC in ovarian cancer.
Authors: Iván Díaz-Padilla; Albiruni Ryan Abdul Razak; Lucas Minig; Marcus Q Bernardini; Josep María Del Campo Journal: Clin Transl Oncol Date: 2012-01 Impact factor: 3.405
Authors: Xiaoxiang Chen; Jing Zhang; Wenjun Cheng; Doo Young Chang; Jianfei Huang; Xuan Wang; Lizhou Jia; Daniel G Rosen; Wei Zhang; Da Yang; David M Gershenson; Anil K Sood; Robert C Bast; Jinsong Liu Journal: Int J Gynecol Cancer Date: 2013-06 Impact factor: 3.437