Interval between debulking surgery and adjuvant chemotherapy is associated with overall survival in patients with advanced ovarian cancer

2018 ◽  
Vol 150 (3) ◽  
pp. 446-450 ◽  
Author(s):  
M. Timmermans ◽  
M.A. van der Aa ◽  
R.I. Lalisang ◽  
P.O. Witteveen ◽  
K.K. Van de Vijver ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Advanced Ovarian Cancer ◽  
Debulking Surgery

Neoadjuvant chemotherapy with six cycles of carboplatin and paclitaxel in advanced ovarian cancer patients not candidates for optimal primary surgery: Safety and effectivenes.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 5540-5540
Author(s):  
Vanessa Costa Miranda ◽  
Angelo Bezerra de Sousa Fede ◽  
Carlos Henrique Dos Anjos ◽  
Juliana Ribeiro da Silva ◽  
Fernando Barbosa Sanchez ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Neoadjuvant Chemotherapy ◽  
Disease Progression ◽  
Advanced Ovarian Cancer ◽  
Length Of Hospital Stay ◽  
Complete Response ◽  
Debulking Surgery ◽  
Stage Iiic ◽  
Primary Debulking Surgery

5540 Background: Primary debulking surgery (PDS) has been considered the standard of treatment in advanced ovarian cancer, while neoadjuvant chemotherapy, three cycles followed by interval debulking (ID) surgery, is a valid treatment alternative for patients with non-resectable disease. This study aimed to show the efficacy and safety of six cycles of neoadjuvant chemotherapy (N-CT) followed by cytoreduction, a single institution experience. Methods: Aretrospective analysis was performed of all patients (pts) with advanced ovarian cancer treated with platinum based N-CT, between January/2004 and February/2012. Results: 97 pts underwent N-CT in our institution; 78.1% and 18.8% the patients had extensive stage IIIC or IV disease at diagnosis, respectively. Median age 60 years (36 – 82). Histologic types: serous 84.5%, adenocarcinoma not specified 11.3%, endometrioide 1.0%. A median of six cycles of chemotherapy were performed. Patients did not received chemotherapy after debulking surgery. During the treatment 31.4% had grade 3/4 toxicity, the most commonly observed toxicities were hematologic toxicities and nausea, four (4.1%) patients died during chemotherapy due to disease progression. After N-CT 24.7% achieved clinical complete response, 57.7% partial response and 12.4% disease progression. From this cohort 63.1% underwent a complete resection of all macroscopic and microscopic disease (R0). Median length of hospital stay and postoperative ICU stay was 5 and 0.8 days respectively, surgical complications were not common however five (7.1%) patients needed second surgery due to operatory complications and 19 pts (27.1%) needed blood transfusion after debulking. With a median follow up of 21.8 months (0.5-139.7), median overall survival and chemotherapy-free interval were 57,7 and 9,5 months, respectively. Conclusions: Six cycles of neoadjuvant carboplatin and paclitaxel is safe, effective and does not increase perioperative and postoperative complications for patients with stage IIIC-IV not candidates for optimal/R0 PDS. The overall survival of this cohort is higher than those treated with interval debulking surgery.

Predictive Factors for Surgical Morbidities and Adjuvant Chemotherapy Delay for Advanced Ovarian Cancer Patients Treated by Primary Debulking Surgery or Interval Debulking Surgery

2018 ◽  
Vol 28 (8) ◽  
pp. 1520-1528 ◽  
Author(s):  
Beatriz Guerreiro Ruiz Castro ◽  
Ricardo dos Reis ◽  
Geórgia Fontes Cintra ◽  
Mileide Maria de Assunção Sousa ◽  
Marcelo de Andrade Vieira ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Adjuvant Chemotherapy ◽  
Predictive Factors ◽  
Surgical Complications ◽  
Advanced Ovarian Cancer ◽  
Debulking Surgery ◽  
General Group ◽  
Primary Debulking Surgery ◽  
Estimated Blood Loss ◽  
Interval Debulking Surgery

ObjectivePostoperative complications and adjuvant chemotherapy delay (ACD) are the most damaging outcomes after surgical treatment of advanced ovarian cancer. Establishing predictive factors should prevent their occurrence.MethodsWe analyzed retrospectively all patients with advanced ovarian cancer who underwent cytoreduction at our institution between December 2010 and May 2016. We evaluated all 30-day complications and considered ACD all cases who did not start adjuvant chemotherapy until 42 days or did not perform it after cytoreductive surgery. These data were analyzed in the general group, and between primary debulking surgery (PDS) and interval debulking surgery (IDS) using χ2 test and Student t test. Relationship of variables was verified using Multiple Logistic Regression.ResultsA total of 83 women were included. Of these, 43 (51.8%) were submitted to PDS and 40 (48.2%) to IDS. In the PDS group, 23 (53.5%) of the patients had complications. For the IDS group, 27 (67.5%) complicated (P = 0.192). Regarding the general group, independent predictors for 30-day complications were presence of comorbidities (odds ratio [OR], 5.466, 95% confidence interval [CI], 1.151–25,972; P = 0.033) and estimated blood loss of greater than 300 mL (OR, 14.407; 95% CI, 2.736–75.863; P = 0.002). In multivariate analysis of the general group, independent predictors for ACD were the presence of hypertension as comorbidity (OR, 3.898; 95% CI, 1.119–13.578; P = 0.033), body mass index of greater than 30 kg/m2 (OR, 5.728; 95% CI, 1.169-28.069; P = 0.031), 30-day reoperation (OR, 21.275; 95% CI, 1.799-251.651; P = 0.015), and fever within 30 days (OR, 11.594; 95% CI, 1.714–78.412; P = 0.012).ConclusionsComorbidities and intraoperative bleeding are the most relevant findings related to surgical complications. Surgical approach (PDS or IDS) was not related with complications. Surgical complications were significantly related to ACD.

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