Comparison of Long-Term Survival Rates of Primary Surgery and Surgery After Neoadjuvant Chemotherapy in Ovarian Cancer
Introduction:To compare long-term survival of primary debulking surgery (PDS) and interval debulking surgery (IDS) after neoadjuvant chemotherapy (NAC) in patients with advanced ovarian cancer.Methods:Patients who underwent debulking surgery for ovarian cancer between 2001 and 2014 were included in...
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| Format: | Article |
| Language: | English |
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Galenos Yayinevi
2019-03-01
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| Series: | İstanbul Medical Journal |
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| Online Access: |
http://imj.galenos.com.tr/archives/archive-detail/article-preview/comparison-of-long-term-survival-rates-of-primary-/26343
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| _version_ | 1797913167647473664 |
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| author | Alpaslan Kaban Samet Topuz Hamdullah Sözen Yavuz Salihoğlu |
| author_facet | Alpaslan Kaban Samet Topuz Hamdullah Sözen Yavuz Salihoğlu |
| author_sort | Alpaslan Kaban |
| collection | DOAJ |
| description | Introduction:To compare long-term survival of primary debulking surgery (PDS) and interval debulking surgery (IDS) after neoadjuvant chemotherapy (NAC) in patients with advanced ovarian cancer.Methods:Patients who underwent debulking surgery for ovarian cancer between 2001 and 2014 were included in the study.Results:Of 378 patients, 191 (50.5%) underwent PDS and 187 (49.5%) underwent IDS. Compared with PDS group, IDS was associated with higher optimal surgical performance (residual <1 cm) (83% vs 65%, p<0.001), lower visible tumor rate in the upper abdomen during surgery (12% vs 46%, p<0.001), lower intraabdominal ascites rate (2% vs 64%, p<0.001), lower postoperative (within 30 days) mortality (0 vs 5) and lower bowel resection/colostomy rate (3% vs 11%, p=0.001). The median follow-up period was 43 (1-161) months. Overall survival (OS) was longer in the PDS group [56.8 months (95% CI: 48.2-65.4) vs 43.5 (95% CI: 38.1-48.8), log-rank test p=0.026]. PDS was superior in both residual subgroups, 64.9 vs 44.6 months (p=0.008) in ≤1 cm group and 41.6 vs 25.3 months (p=0.044) in >1 cm group. The 8-year OS was higher in the PDS group (31.8% vs 12.7%). According to multivariate Cox analysis, age, suboptimal debulking, IDS and presence of tumor in the upper abdomen were independent factors associated with shorter OS duration (hazard ratio: 1.013; 1.606; 1.456 and 1.495, respectively).Conclusion:NAC in patients with FIGO 2010 stage 3 ovarian cancers is useful in reducing tumor spread, surgical morbidity and suboptimal surgery rates. However, long-term survival rates were shorter than the PDS group. |
| first_indexed | 2024-04-10T12:07:35Z |
| format | Article |
| id | doaj.art-06a8947869ab4054ab164fd369abdf01 |
| institution | Directory Open Access Journal |
| issn | 2619-9793 2148-094X |
| language | English |
| last_indexed | 2024-04-10T12:07:35Z |
| publishDate | 2019-03-01 |
| publisher | Galenos Yayinevi |
| record_format | Article |
| series | İstanbul Medical Journal |
| spelling | doaj.art-06a8947869ab4054ab164fd369abdf012023-02-15T16:16:08ZengGalenos Yayineviİstanbul Medical Journal2619-97932148-094X2019-03-01202889310.4274/imj.galenos.2019.9129713049054Comparison of Long-Term Survival Rates of Primary Surgery and Surgery After Neoadjuvant Chemotherapy in Ovarian CancerAlpaslan KabanSamet TopuzHamdullah SözenYavuz SalihoğluIntroduction:To compare long-term survival of primary debulking surgery (PDS) and interval debulking surgery (IDS) after neoadjuvant chemotherapy (NAC) in patients with advanced ovarian cancer.Methods:Patients who underwent debulking surgery for ovarian cancer between 2001 and 2014 were included in the study.Results:Of 378 patients, 191 (50.5%) underwent PDS and 187 (49.5%) underwent IDS. Compared with PDS group, IDS was associated with higher optimal surgical performance (residual <1 cm) (83% vs 65%, p<0.001), lower visible tumor rate in the upper abdomen during surgery (12% vs 46%, p<0.001), lower intraabdominal ascites rate (2% vs 64%, p<0.001), lower postoperative (within 30 days) mortality (0 vs 5) and lower bowel resection/colostomy rate (3% vs 11%, p=0.001). The median follow-up period was 43 (1-161) months. Overall survival (OS) was longer in the PDS group [56.8 months (95% CI: 48.2-65.4) vs 43.5 (95% CI: 38.1-48.8), log-rank test p=0.026]. PDS was superior in both residual subgroups, 64.9 vs 44.6 months (p=0.008) in ≤1 cm group and 41.6 vs 25.3 months (p=0.044) in >1 cm group. The 8-year OS was higher in the PDS group (31.8% vs 12.7%). According to multivariate Cox analysis, age, suboptimal debulking, IDS and presence of tumor in the upper abdomen were independent factors associated with shorter OS duration (hazard ratio: 1.013; 1.606; 1.456 and 1.495, respectively).Conclusion:NAC in patients with FIGO 2010 stage 3 ovarian cancers is useful in reducing tumor spread, surgical morbidity and suboptimal surgery rates. However, long-term survival rates were shorter than the PDS group. http://imj.galenos.com.tr/archives/archive-detail/article-preview/comparison-of-long-term-survival-rates-of-primary-/26343 ChemotherapycytoreductionFIGOovarian carcinoma |
| spellingShingle | Alpaslan Kaban Samet Topuz Hamdullah Sözen Yavuz Salihoğlu Comparison of Long-Term Survival Rates of Primary Surgery and Surgery After Neoadjuvant Chemotherapy in Ovarian Cancer İstanbul Medical Journal Chemotherapy cytoreduction FIGO ovarian carcinoma |
| title | Comparison of Long-Term Survival Rates of Primary Surgery and Surgery After Neoadjuvant Chemotherapy in Ovarian Cancer |
| title_full | Comparison of Long-Term Survival Rates of Primary Surgery and Surgery After Neoadjuvant Chemotherapy in Ovarian Cancer |
| title_fullStr | Comparison of Long-Term Survival Rates of Primary Surgery and Surgery After Neoadjuvant Chemotherapy in Ovarian Cancer |
| title_full_unstemmed | Comparison of Long-Term Survival Rates of Primary Surgery and Surgery After Neoadjuvant Chemotherapy in Ovarian Cancer |
| title_short | Comparison of Long-Term Survival Rates of Primary Surgery and Surgery After Neoadjuvant Chemotherapy in Ovarian Cancer |
| title_sort | comparison of long term survival rates of primary surgery and surgery after neoadjuvant chemotherapy in ovarian cancer |
| topic | Chemotherapy cytoreduction FIGO ovarian carcinoma |
| url |
http://imj.galenos.com.tr/archives/archive-detail/article-preview/comparison-of-long-term-survival-rates-of-primary-/26343
|
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