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Neoadjuvant chemotherapy (NACT) is an effective way of managing elderly women with advanced stage ovarian cancer (FIGO Stage IIIC and IV)
Author(s) -
Glasgow Michelle A.,
Yu Herbert,
Rutherford Thomas J.,
Azodi Masoud,
Silasi DanArin,
Santin Alessandro D.,
Schwartz Peter E.
Publication year - 2012
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23171
Subject(s) - medicine , stage (stratigraphy) , perioperative , chemotherapy , ovarian cancer , retrospective cohort study , cohort , surgery , cytoreductive surgery , oncology , cancer , paleontology , biology
Background To compare outcomes in women ≥ age 70 who receive neoadjuvant chemotherapy (NACT) for advanced epithelial ovarian cancer (EOC) followed by cytoreductive surgery with those undergoing upfront cytoreductive surgery followed by the same chemotherapy. Methods A retrospective cohort study was performed for women ≥ age 70 with Stage IIIC or Stage IV EOC from 1996 to 2009. Results Sixty‐two patients who underwent upfront cytoreductive surgery and 42 patients who received NACT were eligible for analysis. Patients receiving NACT were significantly more likely to have Stage IV disease ( P = 0.004). Cytoreduction to no macroscopic disease was achieved in 71.4% of women who received NACT and 28.1% of women undergoing upfront surgery ( P < 0.001). NACT patients had significantly less blood loss at surgery ( P = 0.01), required fewer small bowel resections ( P = 0.009), had shorter ICU stays ( P = 0.02) and fewer hospital days ( P = 0.04). NACT patients experienced a trend toward an improved progression‐free survival ( P = 0.078); however, no statistically significant differences were found in either the progression‐free or overall survival analyses. Conclusion NACT is associated with reduced perioperative morbidity in elderly patients with advanced stage ovarian cancer. J. Surg. Oncol. 2013;107:195–200. © 2012 Wiley Periodicals, Inc.