Treatment strategies for patients with advanced ovarian cancer undergoing neoadjuvant chemotherapy: interval debulking surgery or additional chemotherapy? / 부인종양
Journal of Gynecologic Oncology
;
: e81-2019.
Article
Dans Anglais
| WPRIM
| ID: wpr-764544
ABSTRACT
OBJECTIVE:
To treat advanced ovarian cancer, interval debulking surgery (IDS) is performed after 3 cycles each of neoadjuvant chemotherapy (NAC) and postoperative chemotherapy (IDS group). If we expect that complete resection cannot be achieved by IDS, debulking surgery is performed after administering additional 3 cycles of chemotherapy without postoperative chemotherapy (Add-C group). We evaluated the survival outcomes of the Add-C group and determined their serum cancer antigen 125 (CA125) levels to predict complete surgery.METHODS:
A retrospective chart review of all stage III and IV ovarian, fallopian tube, and peritoneal cancer patients treated with NAC in 2007–2016 was conducted.RESULTS:
About 117 patients comprised the IDS group and 26 comprised the Add-C group. Univariate and multivariate analyses revealed that Add-C group had an equivalent effect on progression-free survival (PFS; p=0.09) and overall survival (OS; p=0.94) compared with the IDS group. Multivariate analysis revealed that patients who developed residual disease after surgery had worse PFS (hazard ratio [HR]=2.18; 95% confidence interval [CI]=1.45–3.28) and OS (HR=2.33; 95% CI=1.43–3.79), and those who received <6 cycles of chemotherapy had worse PFS (HR=5.30; 95% CI=2.56–10.99) and OS (HR=3.05; 95% CI=1.46–6.38). The preoperative serum CA125 cutoff level was 30 U/mL based on Youden index method.CONCLUSIONS:
Administering 3 additional cycles of chemotherapy followed by debulking surgery exhibited equivalent effects on survival as IDS followed by 3 cycles of postoperative chemotherapy. Preoperative serum CA125 levels of ≤30 U/mL may be a useful predictor of achieving complete surgery.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Tumeurs de l'ovaire
/
Analyse multifactorielle
/
Études rétrospectives
/
Survie sans rechute
/
Antigènes CA-125
/
Traitement néoadjuvant
/
Traitement médicamenteux
/
Trompes utérines
/
Interventions chirurgicales de cytoréduction
/
Méthodes
Type d'étude:
Étude observationnelle
/
Étude pronostique
Limites du sujet:
Femelle
/
Humains
langue:
Anglais
Texte intégral:
Journal of Gynecologic Oncology
Année:
2019
Type:
Article
Documents relatifs à ce sujet
MEDLINE
...
LILACS
LIS