Relative Effectiveness of Neoadjuvant Chemotherapy Versus Primary Surgery in Patients with Advanced Ovarian Cancer


Heru Priyanto1), A. Andrijono2)

 

1)Oncology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hospital

2)Oncology Division, Department of Obstetrics and Gynecology, Faculty of

Medicine, Universitas Indonesia/ Dr. Cipto Mangunkusumo Hospital

 

ABSTRACT

Background: This study aimed to compare the morbidity and disease free pro­gres­sion between patients with advanced ovarian cancer treated with neo­ad­ju­vant chemotherapy (NAC) followed by surgery and those treated conventionally with cytoreductive surgery followed by cytotoxic chemotherapy.

Subjects and method: This was a retrospective-cohort study conducted at Dr. Cipto Mangunkusumo Hospital, Jakarta. A sample of 84 patients with advanced-stage ovarian cancer was selected for this study, consisting of 64 patients treated con­ventionally (CT group) with primary surgery followed by platinum-based adju­vant chemotherapy, 20 patients treated with neoadjuvant chemotherapy, of which 8 patients subsequently underwent interval debulking and adjuvant che­mo­therapy (NAC group). The dependent variables were morbidity and disease free progression. The independent data were neoadjuvant chemotherapy and cyto­­reductive surgery followed by cytotoxic chemotherapy. The data were collected from medical record and questionnaire. Difference in means between the two groups was tested by t-test. Difference in percents between the two groups was tes­ted by chi-square.

Results: The response rate to the NAC assessed at three cycles was 40%. Performan­ce status (Hb, albumin, ascites, pleural effusion, Ca 125, and stage) in the NAC group was worse than CT group.  Disease free progression after 12 and 24 months in the NAC group was 30% and 5%, CT group was 10% and 7.5%, respec­ti­ve­ly. Parameters of surgical aggressiveness (massive bleeding, organ injury, and ICU stay) were lower in the NAC group than the conventional group. Com­pli­ca­tion rate of surgical injury in CT group was 17% and zero in the NAC group.

Conclusion: Neoadjuvant chemotherapy followed by interval debulking in advan­­ced ovarian cancer does not affect disease free progression but reduces mor­bi­dity.

Keywords: neoadjuvant chemotherapy, interval debulking, cytoreductive surgery, cytotoxic chemotherapy, disease free progression, morbidity, advanced ovarian cancer.

Correspondence: Heru Priyanto. Oncology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hospital, Surakarta, Central Java. Email: drherupriyanto@yahoo.com. Mobile: 081331529944.

DOI: https://doi.org/10.26911/theicph.2018.05.04

 

Share this :

View PDF