Impact of the number of Neoadjuvant Chemotherapy (NAC) cycles on survival and morbidity in patients with advanced epithelial ovarian cancer FIGO III-IV
Par : Godfroy, Marine
Document archivé le : 09/09/2019
Objectives : to assess the impact of 3-4 vs 6 cycles of neoadjuvant chemotherapy (NAC) and cytoreductive outcomes on overall survival (OS) and progression free survival (PFS) in patients undergoing interval debulking surgery (IDS) or closing debulking surgery for advanced ovarian cancer. Methods : a retrospective study conducted in patients treated for AEOC and receiving NAC followed by IDS or closing surgery between 2000 and 2017. Patients were analysed according to the number of NAC cycles received: group 1 received 3-4 cycles of NAC followed by IDS and adjuvant chemotherapy and group 2 and 3 received6 cycles of NAC followed byclosing debulking surgery(CDS) (2) or CDS with consolidation chemotherapy (3). Outcomes were stratified by cytoreductive complications, surgical complexity, quality of the surgical resection, stage of the tumoral disease and chemotherapy exposure and tolerance. Results : no effects on OS and PFS of the three different therapeutic sequences. Decreasing of the OS rate was observed in case of bowel resection involved (HR=1.653; IC95(1.120-2.441), p=0.012), transfert in an Intensive Care Unit (HR=2.694; IC95(1.176-6.171), p=0.020). Decreasing of PFS was associated with involved bowel resection, incomplete cytoreduction CC1, and per-post operative complications. Discussion : no difference on PFS or OS was observed between the 3 groups of therapeutics. Furthermore, obtention of a complete surgical cytoreduction and a decrease of the transfert rate in an intensive care unit were associated with a prolongated OS.Necessity of a propective and multicentric study to confirme our impression.
19 NANT 084M
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godfroyMED19.pdf