Effect of neoadjuvant chemotherapy in advanced ovarian carcinoma

ABSTRACT

Background: Ovarian cancer is the second most common gynecological malignancy. Patients with ovarian tumors are often asymptomatic for a long time. Most cases are diagnosed late because effective screening methods are not available. Aim of the study The tumor clearance effect of neoadjuvant chemotherapy in the advanced ovarian tumor in terms of optimal debulking, ascitic fluid volume reduction, blood transfusion requirements and to compare it with those who have not received neoadjuvant chemotherapy. Materials and methods: 25 Patients with advanced ovarian tumor admitted in the Institute of Obstetrics and Gynecology, ISOKGH, Chennai from February 2018 to December 2018 were included in the study. All patients enrolled in the study underwent a detailed physical examination, routine hematological, biochemical investigations, Ultrasound, and CT Scan. For those patients with ascites, ascitic fluid was sent for cytology. When cytology report confirmed that it was Epithelial ovarian tumor, the patient received Neoadjuvant chemotherapy of Cisplatin 75mg/sq. m, Cyclophosphamide 750 mg/sq. m for 3 cycles – 6 weeks. Results: In our study, injury to adjacent structures was present in 7 cases of PDS group (28%) whereas 3 cases in NACT had an injury. Out of the total 10 cases, 2 had bladder injury, 2 had an injury to the small bowel, 3 had a ureteric injury, 2 had a sigmoid colon and the other had a rectal injury. Post-op complications were present in 8 cases of PDS group (32%), 4 cases (16%) of NACT/IDS group in our study. Conclusion: Neoadjuvant chemotherapy is significantly more effective in achieving optimal cytoreduction and reducing the ascitic fluid volume in advanced ovarian cancer. Blood transfusion requirement is significantly less in the neoadjuvant chemotherapy group.