Impact of neoadjuvant chemotherapy cycles on survival of patients with advanced ovarian cancer: A French national multicenter study (FRANCOGYN)

Lecointre, Lise; Velten, Michel; Lodi, Massimo; Saadeh, Ralph; Lavoué, Vincent; Ouldamer, Lobna; Bendifallah, Sofiane; Koskas, Martin; Bolze, Pierre Adrien; Collinet, Pierre; Canlorbe, Geoffroy; Touboul, Cyril; Huchon, Cyrille; Coutant, Charles; Faller, Émilie; Boisramé, Thomas; Gantzer, Justine; Jj, Baldauf; Akladios, Chérif; Ballester, Marcos

doi:10.1016/j.ejogrb.2019.12.001

Cited by 16 publications

(19 citation statements)

References 29 publications

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“…The median follow-up was 63.5 months (CI95% 43.5-83.5). The median overall (OS) and disease-free (DFS) survival for the entire group was 52 (CI95% 43-62) and 20 (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) months, respectively. Among the perioperative factors identified at Cox analysis and at univariate analysis for OS, only the completeness of cytoreduction (CC) score (p < 0.0001), pancreatic resection (p = 0.06) and number of resections (p = 0.08) remained significant at multivariate analysis (Table 3).…”

Section: Resultsmentioning

confidence: 99%

“…Despite excellent response rates to front-line multimodality therapy, including primary debulking surgery followed by intravenous chemotherapy (CHT) or IDS [12][13][14][15], recurrence confined to the peritoneal cavity occurs in up to 70% of patients within 5 years [2][3][4]16]. Since the peritoneum is the primary site of spread and failure in relapses, intraperitoneal chemotherapy has been administered with efficacy in optimally debulked advanced cases, but, criticisms due to the clinical trial's design, higher toxicity, catheter complications and discontinuity prevented this treatment from being widely adopted in clinical practice [1,3,17].…”

Section: Discussionmentioning

confidence: 99%

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Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis from Epithelial Ovarian Cancer: A 20-Year Single-Center Experience

Carboni

Federici

Sperduti

et al. 2021

Cancers

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Despite improvement in treatments, the peritoneum remains the primary site of relapse in most ovarian cancer cases. Patients who underwent cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from epithelial ovarian cancer were reviewed. Kaplan–Meier curves and multivariate Cox analyses were used to identify survival rates and prognostic factors. This study included 158 patients. The procedure was mostly performed for recurrent disease (46.8%) and high-grade serous carcinoma (58.2%). The median peritoneal cancer index was 14, and complete cytoreduction was obtained in 87.9% of cases. Grade IV morbidity occurred in 15.2% of patients, mostly requiring surgical reoperation, and one patient (0.6%) died within 90 days. The median follow-up was 63.5 months. The Kaplan–Meier 5-year overall survival (OS) and disease-free survival (DFS) rates were 42.1% and 24.3%, respectively. Multiple regression logistic analyses demonstrated that the completeness of cytoreduction (CC) score (p ≤ 0.0001), pancreatic resection (p ≤ 0.0001) and number of resections (p = 0.001) were significant factors influencing OS; whereas the CC score (p ≤ 0.0001) and diaphragmatic procedures (p = 0.01) were significant for DFS. The addition of hyperthermic intraperitoneal chemotherapy to standard multimodality therapy may improve outcomes in both primary and recurrent epithelial ovarian cancer without impairing early postoperative results, but the exact timing has not yet been established. Prospective randomized studies will clarify the role and indications of this approach.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis from Epithelial Ovarian Cancer: A 20-Year Single-Center Experience

Carboni

Federici

Sperduti

et al. 2021

Cancers

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“…Reports evaluating the role of interval debulking surgery after more than four cycles of neoadjuvant chemotherapy are controversial. While some have shown that survival is similar to that of patients undergoing interval debulking surgery after three cycles of neoadjuvant chemotherapy,9–12 others have reported poorer prognosis of delayed surgery 13–16. To date, there has been no randomized controlled trial to determine the best timing for interval debulking surgery.…”

Section: Introductionmentioning

confidence: 99%

Survival impact of histological response to neoadjuvant chemotherapy according to number of cycles in patients with advanced ovarian cancer

Bétrian

Ángeles

Moreno

et al. 2022

Int J Gynecol Cancer

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ObjectiveWe sought to evaluate the impact of chemotherapy response score according to the number of cycles of neoadjuvant chemotherapy, on disease-free survival and overall survival, in patients with advanced epithelial ovarian cancer ineligible for primary debulking surgery.MethodsThis multicenter retrospective study included patients with International Federation of Gynecology and Obstetrics (FIGO) stage IIIC-IV epithelial ovarian cancer who underwent 3–4 or 6 cycles of a platinum and taxane-based neoadjuvant chemotherapy, followed by complete cytoreduction surgery (CC-0) or cytoreduction to minimal residual disease (CC-1), between January 2008 and December 2015, in four institutions. Disease-free survival and overall survival were assessed according to the histological response to chemotherapy defined by the validated chemotherapy response score.ResultsA total of 365 patients were included: 219 (60.0%) received 3–4 cycles of neoadjuvant chemotherapy, and 146 (40.0%) had 6 cycles of neoadjuvant chemotherapy before cytoreductive surgery. There were no significant differences in early relapses, disease-free survival, and overall survival according to the number of neoadjuvant chemotherapy cycles. However, regardless of the number cycles of neoadjuvant chemotherapy, persistent extensive histological disease (chemotherapy response score 1–2) was significantly associated with a higher peritoneal cancer index, minimal residual disease (CC-1), and early relapses. Median disease-free survival in patients with complete or near-complete response (score 3) was 28.3 months (95% CI 21.6 to 36.8), whereas it was 16.3 months in patients with chemotherapy response score 1–2 (95% CI 14.7 to 18.0, p<0.001).ConclusionIn our cohort, the number of neoadjuvant chemotherapy cycles was not associated with disease-free survival or overall survival. Chemotherapy response score 3 improved oncological outcome regardless of the number of neoadjuvant chemotherapy cycles.

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“…The main goal for advanced ovarian cancer is satisfactory cytoreductive surgery. In cases where this is not achieved, intermittent debulking surgery (IDS) following NAC has been accepted as an alternative therapeutic strategy for advanced ovarian cancer [ 1 ]. NAC is considered for patients with stage III to IV cancer presenting large tumors for whom satisfactory cytoreductive surgery is not adequately achieved (residual lesions ≤ 1 cm) or those at greater surgical risk [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy evaluation of albumin-bound paclitaxel combined with carboplatin as neoadjuvant chemotherapy for primary epithelial ovarian cancer

Wang

Fan

et al. 2022

BMC Women's Health

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ObjectiveThis study aimed to compare the efficacy of albumin-bound paclitaxel combined with carboplatin (Nab-TC) with that of traditional solvent-based paclitaxel combined with carboplatin (TC) as neoadjuvant chemotherapy (NAC) regimens for primary epithelial ovarian cancer.MethodsEighty patients with advanced primary epithelial ovarian cancer admitted for treatment at the Harbin Medical University Cancer Hospital from January 2015 to January 2020 were retrospectively selected. All patients underwent surgery after 1–4 courses of NAC with Nab-TC or TC regimen. Among the patients included for study, 40 patients in each group.ResultsThe ORR in Nab-TC group was better compared to TC group (45% vs 40%), but the difference was not significant (P = 0.651). While the reduction rate of CA-125 value in the Nab-TC group was significantly better (P < 0.05). The postoperative complication rate such as postoperative blood transfusion (5% vs 35%) and postoperative infusion of human albumin (25% vs 55%) were significantly lower relative to the TC group. The median progression-free survival of the Nab-TC group was significantly longer relative to the TC group (20 months vs 13 months,P = 0.012), and the patient’s quality of life was also better in the Nab-TC group (P < 0.05). Our study demonstrated that Nab-TC regimen and R0 represented the independent prognostic factors.ConclusionThe efficacy of the Nab-TC regimen as NAC for advanced primary epithelial ovarian cancer was non-inferior to that of the TC regimen along with a lower incidence of adverse reactions, a longer PFS and a higher quality of life, supporting its therapeutic value in the clinic.

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Impact of neoadjuvant chemotherapy cycles on survival of patients with advanced ovarian cancer: A French national multicenter study (FRANCOGYN)

Cited by 16 publications

References 29 publications

Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis from Epithelial Ovarian Cancer: A 20-Year Single-Center Experience

Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis from Epithelial Ovarian Cancer: A 20-Year Single-Center Experience

Survival impact of histological response to neoadjuvant chemotherapy according to number of cycles in patients with advanced ovarian cancer

Efficacy evaluation of albumin-bound paclitaxel combined with carboplatin as neoadjuvant chemotherapy for primary epithelial ovarian cancer

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