Neoadjuvant Versus Adjuvant Chemotherapy in Advanced Ovarian Carcinoma

Author(s): Hanan Ramadan Nassar, Ihab Samy Fayek, Alfred Elias Namour, Mostafa Maher El-Gammal

Aim: Aim of this retrospective study was to assess whether there is an advantage of treating women with advanced ovarian cancer with chemotherapy before cytoreductive surgery (neoadjuvant chemotherapy (NACT)) compared with conventional treatment where chemotherapy follows maximal cytoreductive surgery.

Patients and Methods: Include patients with advanced epithelial ovarian cancer (stage III and IV) who underwent surgery from 2009–2015 with optimal cyto-reductive surgery (R0).

Results: The study included 60 patients the mean age for all patients was 53.7 years, a total of 60 patients diagnosed and treated in NCI and Agouza Police hospital in the specified period (2009-2015), with locally advanced epithelial ovarian carcinoma were divided into 2 groups according to the pattern of treatment where 30 patients seemed resectable and primary cytoreductive surgery was carried out (conventional group), and 30 patients seemed unresectable and neoadjuvant chemotherapy (NACT) was given to them followed by interval debulking surgery (IDS). On assessment of the survival we compared the whole number of both groups. The median overall survival time was 45.77 months in the conventional group and 49.06 months in the NACT group.

Conclusion: Primary chemotherapy followed by IDS in a selected group of patients doesn't appear to worsen the prognosis, but it permits a less aggressive surgery to be performed. NACT is not inferior to primary surgery.