Interval debulking Surgery after Neoadjuvant Chemotherapy for Advanced Ovarian Carcinoma, Impact on Patients’ Survival

Mlees, Mohamed A.; Moussa, Hossam R.; Darwish, Sara A.; Sallam, Emad M.

doi:10.21608/asjs.2023.285709

Interval debulking Surgery after Neoadjuvant Chemotherapy for Advanced Ovarian Carcinoma, Impact on Patients’ Survival

Document Type : Original Article

Authors

¹ Department of General Surgery, Surgical Oncology Unit, Faculty of Medicine, Tanta University, Egypt

² Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Tanta University, Egypt

³ Department of Vascular and Endovascular Surgery, Faculty of Medicine, Tanta University, Egypt

10.21608/asjs.2023.285709

Abstract

Objective: The standard management of advanced epithelial ovarian carcinoma (EOC) is complete tumor cytoreduction
followed by chemotherapy. This study prospectively evaluated the outcomes of interval debulking surgery (IDS) after
neoadjuvant chemotherapy (NACT) in terms of pathological response, surgical outcome, and patients’ survival.
Patients and methods: The study was carried out between January 2018 and December 2021, 72 patients with a denovo stage III-IV EOC were enrolled in the study, they received IDS after platinum based NACT to achieve a complete surgical debulking to no macroscopic residual disease (R0) or optimal debulking to < 1cm residual disease (R1). Patients’ characteristics, operative details, complications, overall survival (OS) and the progression free survival (PFS) were analyzed.
Results: Complete pathological response (CPR) was reported in 8 patients (11.1%). The complete debulking surgery was
achieved in 39 patients (54.2%) while optimal debulking was done in 33 patients (45.8%). PFS was better in patients with
complete pathological response (CPR) 44.54 months than patients with Micro/ Macro pathological response (Micro/ Macro PR) 33.39 month, P = 0.018. PFS was 39.02 months for patients undergone complete cytoreduction versus 31.47 months for patients undergone optimal cytoreduction, P = 0.010. While OS was 45.09 months for patients undergone complete cytoreduction versus 35,97 months for patients undergone optimal cytoreduction, P = 0.004.
Conclusion: Combination of NACT and IDS in advanced ovarian carcinoma can result in better pathological response, surgical resection outcome and decreased minimal residual disease leading to improved OS and PFS.

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