Effect of tumor burden and radical surgery on survival difference between upfront, early interval or delayed cytoreductive surgery in ovarian cancer
Angeles, Martina Aida (Institut Universitaire du Cancer de Toulouse Oncopole)
Cabarrou, Bastien (Institut Universitaire du Cancer de Toulouse Oncopole)
Gil-Moreno, Antonio 1965- (Vall d'Hebron Institut d'Oncologia)
Pérez-Benavente, Assumpció (Vall d'Hebron Institut d'Oncologia)
Spagnolo, Emanuela (Hospital Universitario La Paz (Madrid))
Rychlik, Agnieszka (Department of Gynaecologic Oncology, Maria Skłodowska-Curie National Research Institute of Oncology)
Martínez-Gómez, Carlos (INSERM CRCT 1 (França))
Guyon, Frédéric (Department of Surgical Oncology, Institut Bergonié (França))
Zapardiel, Ignacio (Hospital Universitario La Paz (Madrid))
Querleu, Denis (Honorary Professor of the University of Toulouse)
Illac, Claire (Institut Universitaire du Cancer de Toulouse Oncopole)
Migliorelli, Federico (Department of Gynaecology and Obstetrics, Centre Hospitalier Intercommunal des Vallées de l'Ariège (França))
Bétrian, Sarah (Institut Universitaire du Cancer de Toulouse Oncopole)
Ferron, Gwénaël (INSERM CRCT 19 (França))
Hernández Gutierrez, Alicia (Instituto de Investigación Sanitaria del Hospital Universitario La Paz)
Martinez, Alejandra (INSERM CRCT 19 (França))
Universitat Autònoma de Barcelona

Date:	2021
Abstract:	We sought to evaluate the impact on survival of tumor burden and surgical complexity in relation to the number of cycles of neoadjuvant chemotherapy (NACT) in patients with advanced ovarian cancer (OC) with minimal (CC-1) or no residual disease (CC-0). This retrospective study included patients with International Federation of Gynaecology and Obstetrics IIIC-IV stage OC who underwent debulking surgery at 4 high-volume institutions between January 2008 and December 2015. We assessed the overall survival (OS) of primary debulking surgery (PDS group), early interval debulking surgery after 3-4 cycles of NACT (early IDS group) and delayed debulking surgery after 6 cycles (DDS group) with CC-0 or CC-1 according to peritoneal cancer index (PCI) and Aletti score. Five hundred forty-nine women were included: 175 (31. 9%) had PDS, 224 (40. 8%) early IDS and 150 (27. 3%) DDS. Regardless of Aletti score, median OS after PDS was significantly higher than after early IDS or DDS, but the survival difference was higher in women with an Aletti score <8. Among patients with PCI ≤10, median OS after PDS was significantly higher than after early IDS or DDS. In women with PCI >10, there were no differences between PDS and early IDS, but DDS was associated with decreased OS. The benefit of complete PDS compared with NACT was maximal in patients with a low complexity score. In patients with low tumor burden, there was a survival benefit of PDS over early IDS or DDS. In women with high tumor load, DDS impaired the oncological outcome.
Grants:	"la Caixa" Foundation CF/BQ/EU18/11650038
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Ovarian Neoplasms ; Fallopian Tube Neoplasms ; Peritoneal Neoplasms ; Cytoreduction Surgical Procedures ; Neoadjuvant Therapy ; Tumor Burden
Published in:	Journal of Gynecologic Oncology, Vol. 32 (august 2021) , ISSN 2005-0399

DOI: 10.3802/jgo.2021.32.e78
PMID: 34431252

14 p, 2.0 MB

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