Surgery in Advanced Ovary Cancer: Primary versus Interval Cytoreduction
Primary debulking surgery (PDS) has remained the only treatment of ovarian cancer with survival advantage since its development in the 1970s. However, survival advantage is only observed in patients who are optimally resected. Neoadjuvant chemotherapy (NACT) has emerged as an alternative for patient...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-04-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/4/988 |
| _version_ | 1827621037522550784 |
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| author | Mackenzie Cummings Olivia Nicolais Mark Shahin |
| author_facet | Mackenzie Cummings Olivia Nicolais Mark Shahin |
| author_sort | Mackenzie Cummings |
| collection | DOAJ |
| description | Primary debulking surgery (PDS) has remained the only treatment of ovarian cancer with survival advantage since its development in the 1970s. However, survival advantage is only observed in patients who are optimally resected. Neoadjuvant chemotherapy (NACT) has emerged as an alternative for patients in whom optimal resection is unlikely and/or patients with comorbidities at high risk for perioperative complications. The purpose of this review is to summarize the evidence to date for PDS and NACT in the treatment of stage III/IV ovarian carcinoma. We systematically searched the PubMed database for relevant articles. Prior to 2010, NACT was reserved for non-surgical candidates. After publication of EORTC 55971, the first randomized trial demonstrating non-inferiority of NACT followed by interval debulking surgery, NACT was considered in a wider breadth of patients. Since EORTC 55971, 3 randomized trials—CHORUS, JCOG0602, and SCORPION—have studied NACT versus PDS. While CHORUS supported EORTC 55971, JCOG0602 failed to demonstrate non-inferiority and SCORPION failed to demonstrate superiority of NACT. Despite conflicting data, a subset of patients would benefit from NACT while preserving survival including poor surgical candidates and inoperable disease. Further randomized trials are needed to assess the role of NACT. |
| first_indexed | 2024-03-09T10:56:09Z |
| format | Article |
| id | doaj.art-4aa10f12e28349d6ba4022b0128045fc |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T10:56:09Z |
| publishDate | 2022-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-4aa10f12e28349d6ba4022b0128045fc2023-12-01T01:35:12ZengMDPI AGDiagnostics2075-44182022-04-0112498810.3390/diagnostics12040988Surgery in Advanced Ovary Cancer: Primary versus Interval CytoreductionMackenzie Cummings0Olivia Nicolais1Mark Shahin2Department of Obstetrics and Gynecology, Jefferson Abington Hospital, Abington, PA 19001, USADepartment of Obstetrics and Gynecology, Jefferson Abington Hospital, Abington, PA 19001, USAAsplundh Cancer Pavilion, Sidney Kimmel Cancer Center, Hanjani Institute for Gynecologic Oncology, Thomas Jefferson University, Willow Grove, PA 19090, USAPrimary debulking surgery (PDS) has remained the only treatment of ovarian cancer with survival advantage since its development in the 1970s. However, survival advantage is only observed in patients who are optimally resected. Neoadjuvant chemotherapy (NACT) has emerged as an alternative for patients in whom optimal resection is unlikely and/or patients with comorbidities at high risk for perioperative complications. The purpose of this review is to summarize the evidence to date for PDS and NACT in the treatment of stage III/IV ovarian carcinoma. We systematically searched the PubMed database for relevant articles. Prior to 2010, NACT was reserved for non-surgical candidates. After publication of EORTC 55971, the first randomized trial demonstrating non-inferiority of NACT followed by interval debulking surgery, NACT was considered in a wider breadth of patients. Since EORTC 55971, 3 randomized trials—CHORUS, JCOG0602, and SCORPION—have studied NACT versus PDS. While CHORUS supported EORTC 55971, JCOG0602 failed to demonstrate non-inferiority and SCORPION failed to demonstrate superiority of NACT. Despite conflicting data, a subset of patients would benefit from NACT while preserving survival including poor surgical candidates and inoperable disease. Further randomized trials are needed to assess the role of NACT.https://www.mdpi.com/2075-4418/12/4/988advanced ovarian cancersurgeryprimary debulking surgeryneoadjuvant chemotherapyinterval debulking surgeryEORTC 55971 |
| spellingShingle | Mackenzie Cummings Olivia Nicolais Mark Shahin Surgery in Advanced Ovary Cancer: Primary versus Interval Cytoreduction Diagnostics advanced ovarian cancer surgery primary debulking surgery neoadjuvant chemotherapy interval debulking surgery EORTC 55971 |
| title | Surgery in Advanced Ovary Cancer: Primary versus Interval Cytoreduction |
| title_full | Surgery in Advanced Ovary Cancer: Primary versus Interval Cytoreduction |
| title_fullStr | Surgery in Advanced Ovary Cancer: Primary versus Interval Cytoreduction |
| title_full_unstemmed | Surgery in Advanced Ovary Cancer: Primary versus Interval Cytoreduction |
| title_short | Surgery in Advanced Ovary Cancer: Primary versus Interval Cytoreduction |
| title_sort | surgery in advanced ovary cancer primary versus interval cytoreduction |
| topic | advanced ovarian cancer surgery primary debulking surgery neoadjuvant chemotherapy interval debulking surgery EORTC 55971 |
| url | https://www.mdpi.com/2075-4418/12/4/988 |
| work_keys_str_mv | AT mackenziecummings surgeryinadvancedovarycancerprimaryversusintervalcytoreduction AT olivianicolais surgeryinadvancedovarycancerprimaryversusintervalcytoreduction AT markshahin surgeryinadvancedovarycancerprimaryversusintervalcytoreduction |