Carsten Lindberg Fagö-Olsen1, Bent Ottesen2, Henrik Kehlet3, Sofie L Antonsen2, Ib J Christensen4, Algirdas Markauskas5, Berit J Mosgaard6, Christian Ottosen2, Charlotte H Soegaard7, Erik Soegaard-Andersen8, Claus Hoegdall2. 1. Department of Gynecology and Obstetrics, Rigshospitalet, Copenhagen University Hospital, Denmark. Electronic address: carstenlo@gmail.com. 2. Department of Gynecology and Obstetrics, Rigshospitalet, Copenhagen University Hospital, Denmark. 3. Section of Surgical Pathophysiology, Rigshospitalet, Copenhagen University Hospital, Denmark. 4. The Finsen Laboratory and Biotech Research and Innovation Center (BRIC), Rigshospitalet, Copenhagen University Hospital, Denmark. 5. Department of Gynecology and Obstetrics, Odense University Hospital, Denmark. 6. Department of Gynecology and Obstetrics, Rigshospitalet, Copenhagen University Hospital, Denmark; Department of Gynecology and Obstetrics, Herlev Hospital, Copenhagen University Hospital, Denmark. 7. Department of Gynecology and Obstetrics, Aarhus University Hospital, Denmark. 8. Department of Gynecology and Obstetrics, Aalborg University Hospital, Denmark.
Abstract
OBJECTIVE: In Denmark, the proportion of women with ovarian cancer treated with neoadjuvant chemotherapy (NACT) has increased, and the use of NACT varies among center hospitals. We aimed to evaluate the impact of first-line treatment on surgical outcome and median overall survival (MOS). METHODS: All patients treated in Danish referral centers with stage IIIC or IV epithelial ovarian cancer from January 2005 to October 2011 were included. Data were obtained from the Danish Gynecological Cancer Database, the Danish National Patient Register and medical records. RESULTS: Of the 1677 eligible patients, 990 (59%) were treated with primary debulking surgery (PDS), 515 (31%) with NACT, and 172 (10%) received palliative treatment. Of the patients referred to NACT, 335 (65%) received interval debulking surgery (IDS). Patients treated with NACT-IDS had shorter operation times, less blood loss, less extensive surgery, fewer intraoperative complications and a lower frequency of residual tumor (p < 0.05 for all). No difference in MOS was found between patients treated with PDS (31.9 months) and patients treated with NACT-IDS (29.4 months), p = 0.099. Patients without residual tumor after surgery had better MOS when treated with PDS compared with NACT-IDS (55.5 and 36.7 months, respectively, p = 0.002). In a multivariate analysis, NACT-IDS was associated with increased risk of death after two years of follow-up (HR: 1.81; CI: 1.39-2.35). CONCLUSIONS: No difference in MOS was observed between PDS and NACT-IDS. However, patients without residual tumor had superior MOS when treated with PDS, and NACT-IDS could be associated with increased risk of death after two years of follow-up.
OBJECTIVE: In Denmark, the proportion of women with ovarian cancer treated with neoadjuvant chemotherapy (NACT) has increased, and the use of NACT varies among center hospitals. We aimed to evaluate the impact of first-line treatment on surgical outcome and median overall survival (MOS). METHODS: All patients treated in Danish referral centers with stage IIIC or IV epithelial ovarian cancer from January 2005 to October 2011 were included. Data were obtained from the Danish Gynecological Cancer Database, the Danish National Patient Register and medical records. RESULTS: Of the 1677 eligible patients, 990 (59%) were treated with primary debulking surgery (PDS), 515 (31%) with NACT, and 172 (10%) received palliative treatment. Of the patients referred to NACT, 335 (65%) received interval debulking surgery (IDS). Patients treated with NACT-IDS had shorter operation times, less blood loss, less extensive surgery, fewer intraoperative complications and a lower frequency of residual tumor (p < 0.05 for all). No difference in MOS was found between patients treated with PDS (31.9 months) and patients treated with NACT-IDS (29.4 months), p = 0.099. Patients without residual tumor after surgery had better MOS when treated with PDS compared with NACT-IDS (55.5 and 36.7 months, respectively, p = 0.002). In a multivariate analysis, NACT-IDS was associated with increased risk of death after two years of follow-up (HR: 1.81; CI: 1.39-2.35). CONCLUSIONS: No difference in MOS was observed between PDS and NACT-IDS. However, patients without residual tumor had superior MOS when treated with PDS, and NACT-IDS could be associated with increased risk of death after two years of follow-up.
Authors: Ross F Harrison; Scott B Cantor; Charlotte C Sun; Mariana Villanueva; Shannon N Westin; Nicole D Fleming; Iakovos Toumazis; Anil K Sood; Karen H Lu; Larissa A Meyer Journal: Gynecol Oncol Date: 2021-01-31 Impact factor: 5.482
Authors: Nicole D Fleming; Shannon N Westin; J Alejandro Rauh-Hain; Pamela T Soliman; Bryan M Fellman; Robert L Coleman; Larissa A Meyer; Aaron Shafer; Lauren P Cobb; Amir Jazaeri; Karen H Lu; Anil K Sood Journal: Gynecol Oncol Date: 2021-04-07 Impact factor: 5.304
Authors: P Georgeena; Anupama Rajanbabu; D K Vijaykumar; K Pavithran; K R Sundaram; K S Deepak; M R Sanal Journal: Ecancermedicalscience Date: 2016-02-04
Authors: Angelo Di Giorgio; Pierandrea De Iaco; Michele De Simone; Alfredo Garofalo; Giovanni Scambia; Antonio Daniele Pinna; Giorgio Maria Verdecchia; Luca Ansaloni; Antonio Macrì; Paolo Cappellini; Valerio Ceriani; Giorgio Giorda; Daniele Biacchi; Marco Vaira; Mario Valle; Paolo Sammartino Journal: Ann Surg Oncol Date: 2016-11-28 Impact factor: 5.344