Optimal Time Interval between Neoadjuvant Platinum-Based Chemotherapy and Interval Debulking Surgery in High-Grade Serous Ovarian Cancer
Background: There is limited data on the optimal time interval between the last dose of neoadjuvant chemotherapy (NACT) and interval debulking surgery (IDS) in high-grade serous ovarian carcinoma (HGSC). Methods: We retrospectively identified patients with stage IIIC/IV HGSC who received NACT follow...
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| Format: | Article |
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MDPI AG
2023-07-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/13/3519 |
| _version_ | 1797592000013271040 |
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| author | Angeliki Andrikopoulou Charalampos Theofanakis Christos Markellos Maria Kaparelou Konstantinos Koutsoukos Kleoniki Apostolidou Nikolaos Thomakos Dimitrios Haidopoulos Alexandros Rodolakis Meletios-Athanasios Dimopoulos Flora Zagouri Michalis Liontos |
| author_facet | Angeliki Andrikopoulou Charalampos Theofanakis Christos Markellos Maria Kaparelou Konstantinos Koutsoukos Kleoniki Apostolidou Nikolaos Thomakos Dimitrios Haidopoulos Alexandros Rodolakis Meletios-Athanasios Dimopoulos Flora Zagouri Michalis Liontos |
| author_sort | Angeliki Andrikopoulou |
| collection | DOAJ |
| description | Background: There is limited data on the optimal time interval between the last dose of neoadjuvant chemotherapy (NACT) and interval debulking surgery (IDS) in high-grade serous ovarian carcinoma (HGSC). Methods: We retrospectively identified patients with stage IIIC/IV HGSC who received NACT followed by IDS during a 15-year period (January 2003–December 2018) in our Institution. Results: Overall, 115 patients with stage IIIC/IV HGSC were included. The median age of diagnosis was 62.7 years (IQR: 14.0). A total of 76.5% (88/115) of patients were diagnosed with IIIC HGSC and 23.5% (27/115) with IV HGSC. Median PFS was 15.7 months (95% CI: 13.0–18.5), and median OS was 44.7 months (95% CI: 38.8–50.5). Patients were categorized in groups according to the time interval from NACT to IDS: <4 weeks (group A); 4–5 weeks (group B); 5–6 weeks (group C); >6 weeks (group D). Patients with a time interval IDS to NACT ≥4 weeks had significantly shorter PFS (<i>p</i> = 0.004) and OS (<i>p</i> = 0.002). Median PFS was 26.6 months (95% CI: 24–29.2) for patients undergoing IDS <4 weeks after NACT vs. 14.4 months (95% CI: 12.6–16.2) for those undergoing IDS later (<i>p</i> = 0.004). Accordingly, median OS was 66.3 months (95% CI: 39.1–93.4) vs. 39.4 months (95% CI: 31.8–47.0) in the <4 week vs. >4 week time interval NACT to IDS groups (<i>p</i> = 0.002). On multivariate analysis, the short time interval (<4 weeks) from NACT to IDS was an independent factor of PFS (<i>p</i> = 0.004) and OS (<i>p</i> = 0.003). Conclusion: We have demonstrated that performing IDS within four weeks after NACT may be associated with better survival outcomes. Multidisciplinary coordination among ovarian cancer patients is required to avoid any unnecessary delays. |
| first_indexed | 2024-03-11T01:45:34Z |
| format | Article |
| id | doaj.art-e3cd9de979ec473685401d2a2293d75d |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T01:45:34Z |
| publishDate | 2023-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-e3cd9de979ec473685401d2a2293d75d2023-11-18T16:18:09ZengMDPI AGCancers2072-66942023-07-011513351910.3390/cancers15133519Optimal Time Interval between Neoadjuvant Platinum-Based Chemotherapy and Interval Debulking Surgery in High-Grade Serous Ovarian CancerAngeliki Andrikopoulou0Charalampos Theofanakis1Christos Markellos2Maria Kaparelou3Konstantinos Koutsoukos4Kleoniki Apostolidou5Nikolaos Thomakos6Dimitrios Haidopoulos7Alexandros Rodolakis8Meletios-Athanasios Dimopoulos9Flora Zagouri10Michalis Liontos11Department of Clinical Therapeutics, Alexandra Hospital, Medical School, 11528 Athens, Greece1st Department of Obstetrics and Gynecology, Alexandra Hospital, Medical School, 11528 Athens, GreeceDepartment of Clinical Therapeutics, Alexandra Hospital, Medical School, 11528 Athens, GreeceDepartment of Clinical Therapeutics, Alexandra Hospital, Medical School, 11528 Athens, GreeceDepartment of Clinical Therapeutics, Alexandra Hospital, Medical School, 11528 Athens, GreeceDepartment of Clinical Therapeutics, Alexandra Hospital, Medical School, 11528 Athens, Greece1st Department of Obstetrics and Gynecology, Alexandra Hospital, Medical School, 11528 Athens, Greece1st Department of Obstetrics and Gynecology, Alexandra Hospital, Medical School, 11528 Athens, Greece1st Department of Obstetrics and Gynecology, Alexandra Hospital, Medical School, 11528 Athens, GreeceDepartment of Clinical Therapeutics, Alexandra Hospital, Medical School, 11528 Athens, GreeceDepartment of Clinical Therapeutics, Alexandra Hospital, Medical School, 11528 Athens, GreeceDepartment of Clinical Therapeutics, Alexandra Hospital, Medical School, 11528 Athens, GreeceBackground: There is limited data on the optimal time interval between the last dose of neoadjuvant chemotherapy (NACT) and interval debulking surgery (IDS) in high-grade serous ovarian carcinoma (HGSC). Methods: We retrospectively identified patients with stage IIIC/IV HGSC who received NACT followed by IDS during a 15-year period (January 2003–December 2018) in our Institution. Results: Overall, 115 patients with stage IIIC/IV HGSC were included. The median age of diagnosis was 62.7 years (IQR: 14.0). A total of 76.5% (88/115) of patients were diagnosed with IIIC HGSC and 23.5% (27/115) with IV HGSC. Median PFS was 15.7 months (95% CI: 13.0–18.5), and median OS was 44.7 months (95% CI: 38.8–50.5). Patients were categorized in groups according to the time interval from NACT to IDS: <4 weeks (group A); 4–5 weeks (group B); 5–6 weeks (group C); >6 weeks (group D). Patients with a time interval IDS to NACT ≥4 weeks had significantly shorter PFS (<i>p</i> = 0.004) and OS (<i>p</i> = 0.002). Median PFS was 26.6 months (95% CI: 24–29.2) for patients undergoing IDS <4 weeks after NACT vs. 14.4 months (95% CI: 12.6–16.2) for those undergoing IDS later (<i>p</i> = 0.004). Accordingly, median OS was 66.3 months (95% CI: 39.1–93.4) vs. 39.4 months (95% CI: 31.8–47.0) in the <4 week vs. >4 week time interval NACT to IDS groups (<i>p</i> = 0.002). On multivariate analysis, the short time interval (<4 weeks) from NACT to IDS was an independent factor of PFS (<i>p</i> = 0.004) and OS (<i>p</i> = 0.003). Conclusion: We have demonstrated that performing IDS within four weeks after NACT may be associated with better survival outcomes. Multidisciplinary coordination among ovarian cancer patients is required to avoid any unnecessary delays.https://www.mdpi.com/2072-6694/15/13/3519ovarian cancerIDStime intervalcytoreductive surgeryneoadjuvantprogression-free survival |
| spellingShingle | Angeliki Andrikopoulou Charalampos Theofanakis Christos Markellos Maria Kaparelou Konstantinos Koutsoukos Kleoniki Apostolidou Nikolaos Thomakos Dimitrios Haidopoulos Alexandros Rodolakis Meletios-Athanasios Dimopoulos Flora Zagouri Michalis Liontos Optimal Time Interval between Neoadjuvant Platinum-Based Chemotherapy and Interval Debulking Surgery in High-Grade Serous Ovarian Cancer Cancers ovarian cancer IDS time interval cytoreductive surgery neoadjuvant progression-free survival |
| title | Optimal Time Interval between Neoadjuvant Platinum-Based Chemotherapy and Interval Debulking Surgery in High-Grade Serous Ovarian Cancer |
| title_full | Optimal Time Interval between Neoadjuvant Platinum-Based Chemotherapy and Interval Debulking Surgery in High-Grade Serous Ovarian Cancer |
| title_fullStr | Optimal Time Interval between Neoadjuvant Platinum-Based Chemotherapy and Interval Debulking Surgery in High-Grade Serous Ovarian Cancer |
| title_full_unstemmed | Optimal Time Interval between Neoadjuvant Platinum-Based Chemotherapy and Interval Debulking Surgery in High-Grade Serous Ovarian Cancer |
| title_short | Optimal Time Interval between Neoadjuvant Platinum-Based Chemotherapy and Interval Debulking Surgery in High-Grade Serous Ovarian Cancer |
| title_sort | optimal time interval between neoadjuvant platinum based chemotherapy and interval debulking surgery in high grade serous ovarian cancer |
| topic | ovarian cancer IDS time interval cytoreductive surgery neoadjuvant progression-free survival |
| url | https://www.mdpi.com/2072-6694/15/13/3519 |
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