Primary and Interval Debulking Surgery Provide Similar Survival and Platinum Sensitivity Outcomes in Advanced Ovarian Cancer: A Retrospective Study

Abstract

Background/Aim: CHORUS and EORTC55971 trials demonstrated that neoadjuvant chemotherapy followed by interval debulking surgery (IDS) or primary debulking surgery (PDS) offered the same survival rates. These trials have since been criticised due to poor surgical complexity. We compared overall (OS), progression free (PFS), and platinum sensitivity in advanced ovarian cancer (AOC) patients undergoing IDS or PDS, who had received either intermediate or high complexity surgery to achieve complete cytoreduction. Patients and Methods: All patients with AOC treated between February 2014 and May 2019 obtaining complete cytoreduction with intermediate/high surgical complexity were included. Recurrence was defined according to GCIG criteria on radiological findings and/or CA125 levels. Results: Seventy-one patients (38 PDS and 33 IDS) with full recurrence data were identified. No statistical difference was seen between groups in OS, PFS or platinum sensitive interval. Conclusion: PDS or IDS were both acceptable treatment options for AOC, showing similar survival and platinum sensitivity outcomes in patients undergoing intermediate or high complexity surgery.

Surgery in Advanced Ovary Cancer: Primary versus Interval Cytoreduction

“…In addition to large retrospective studies using national databases, our search yielded conflicting data from retrospective single institution studies comparing PDS to NACT. Of these studies, 13 showed no difference in survival between NACT and PDS [108][109][110][111][112][113][114][115][116][117][118][119][120][121][122][123], 16 studies showed better survival in the PDS group [124][125][126][127][128][129][130][131][132][133][134][135][136][137][138][139], and only 2 studies demonstrated superiority of NACT to PDS [140,141]. Our search yielded one prospective observational study showing better survival in the PDS group than NACT and one multiinstitutional retrospective study showing no difference in median OS but a higher risk of death at 2 years in the NACT group [142,143].…”