Manizheh Sayyah-Melli1, Gita Kashi Zonoozi2, Shahryar Hashemzadeh3, Ali Esfahani4, Elaheh Ouladehsahebmadarek1, Mehry Jafary Shobeiry1, Parvin Mostafa Garabaghi1, Azhough Ramin5. 1. Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, 513866449 Tabriz, Iran. 2. Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, 513866449 Tabriz, Iran ; Department of General Surgery, Faculty of Medicine, Tabriz University Medical Sciences, Tabriz, Iran ; Department of Hematology and Oncology, Faculty of Medicine, Tabriz University Medical Sciences, Tabriz, Iran. 3. Department of General Surgery, Faculty of Medicine, Tabriz University Medical Sciences, Tabriz, Iran. 4. Department of Hematology and Oncology, Faculty of Medicine, Tabriz University Medical Sciences, Tabriz, Iran. 5. Department of General Surgery, Faculty of Medicine, Tabriz University Medical Sciences, Tabriz, Iran ; Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, 513866449 Tabriz, Iran.
Abstract
PURPOSE: Ovarian cancer is the sixth common cancer in women in developed countries. In severe cases, the optimal debulking is necessary. In order to increase optimal debulking and reduce preoperative complications, neoadjuvant chemotherapy followed by debulking surgery, and then chemotherapy again is introduced as substitute for primary surgery. In this study, we aim to evaluate perioperative outcome after neoadjuvant chemotherapy with carboplatin/paclyaxol in comparison with primary cytoreduction in patients with advanced ovarian cancer. METHODS: In this prospective study, 60 patients with advanced ovarian cancer due to the disease severity were assigned into neoadjuvant chemotherapy (n = 30) or control (n = 30) groups. In neoadjuvant chemotherapy group, patients received three cycles of carboplatin (5-6 area under the curve) and paclitaxel (175 mg/m(2)) preoperatively followed by interval surgery. The control group received primary surgery plus adjuvant chemotherapy. Preoperative outcome was compared between groups. RESULTS:Neoadjuvant group had significantly lower mean levels of CA 125 (p = 0.01) and less severe bleeding (p = 0.03) than control group. There was no significant difference between surgery time, preoperative complications, residual mass less than 1 cm, and hospital stay between groups. There was no mortality during the study. CONCLUSION:Neoadjuvant chemotherapy caused less severe bleeding, but has no effect in decreasing complications after surgery; however, neoadjuvant chemotherapy followed by interval debulking surgery was not superior to primary debulking surgery followed by chemotherapy as a treatment option for patients with advanced ovarian carcinoma in this study.
RCT Entities:
PURPOSE:Ovarian cancer is the sixth common cancer in women in developed countries. In severe cases, the optimal debulking is necessary. In order to increase optimal debulking and reduce preoperative complications, neoadjuvant chemotherapy followed by debulking surgery, and then chemotherapy again is introduced as substitute for primary surgery. In this study, we aim to evaluate perioperative outcome after neoadjuvant chemotherapy with carboplatin/paclyaxol in comparison with primary cytoreduction in patients with advanced ovarian cancer. METHODS: In this prospective study, 60 patients with advanced ovarian cancer due to the disease severity were assigned into neoadjuvant chemotherapy (n = 30) or control (n = 30) groups. In neoadjuvant chemotherapy group, patients received three cycles of carboplatin (5-6 area under the curve) and paclitaxel (175 mg/m(2)) preoperatively followed by interval surgery. The control group received primary surgery plus adjuvant chemotherapy. Preoperative outcome was compared between groups. RESULTS: Neoadjuvant group had significantly lower mean levels of CA 125 (p = 0.01) and less severe bleeding (p = 0.03) than control group. There was no significant difference between surgery time, preoperative complications, residual mass less than 1 cm, and hospital stay between groups. There was no mortality during the study. CONCLUSION: Neoadjuvant chemotherapy caused less severe bleeding, but has no effect in decreasing complications after surgery; however, neoadjuvant chemotherapy followed by interval debulking surgery was not superior to primary debulking surgery followed by chemotherapy as a treatment option for patients with advanced ovarian carcinoma in this study.
Entities:
Keywords:
Advanced stage; Neoadjuvant chemotherapy; Ovarian cancer; Primary debulking surgery
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