RETROSPECTIVE ANALYSIS OF LONG-TERM SURVIVAL OUTCOMES OF PRIMARY CYTOREDUCTION AND NEOADJUVANT CHEMOTHERAPY IN PATIENTS WITH OVARIAN CANCER STAGE IIIC–IV
https://doi.org/10.18027/2224-5057-2018-8-3-86-94
Abstract
The choice of treatment strategy in patients with stage IIIC‑IV ovarian cancer (OC) remains the subject of numerous discussions. The reason for this is the unsatisfactory results of randomized trials and the low frequency of primary complete debulking surgery in these studies. We conducted a retrospective analysis to evaluate the survival outcomes in patients with OC stage IIIC–IV (n=314) who underwent treatment between 1995 and 2017. The median progression free survival for primary surgery was 15.6 months, after interval debulking – 11.5 months (p=0.002, HR 0.61: 95 % CI 0.39–0.81). The primary cytoreduction significantly increased the median of overall survival by 19.6 months: from 38.0 months after interval debulking up to 57.6 months after primary cytoreduction (p=0.04, HR 0.64: 95 % CI 0.41–0.99). An increase in the number of optimal interval debulking does not lead to an improvement in the long-term results of treatment in the group of patients after neoadjuvant chemotherapy. Our analysis over the past 20 years has shown that improvement in treatment outcomes is only observed in the primary cytoreduction group due to an increase in the number of complete optimal cytoreductive surgery.
About the Authors
A. S. TjulandinaRussian Federation
Alexandra S. Tjulandina, MD, PhD Med, Senior Clinical Researcher, Department of Clinical Pharmacology and Chemotherapy.
Moscow.
A. A. Rumyantsev
Russian Federation
Alexey A. Rumyantsev, post-graduate student, Department of Clinical Pharmacology and Сhemotherapy.
Moscow.
K. Y. Morkhov
Russian Federation
Konstantin Yu. Morkhov, MD, PhD Med, Senior Clinical Researcher, Department of Combined and Radiation Therapy for Gynecological Cancer.
Moscow.
V. M. Nechushkina
Russian Federation
Valentina M. Nechushkina, MD, DSc Med, Leading Clinical Researcher, Department of Combined and Radiation Therapy for Gynecological Cancer; Professor of the Department of Oncology and Radiation Therapy, Medical Faculty.
Moscow.
S. A. Tjulandin
Russian Federation
Sergei A. Tjulandin, MD, DSc Med, Professor, Head of the Department of Clinical Pharmacology and Chemotherapy.
Moscow.
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Review
For citations:
Tjulandina A.S., Rumyantsev A.A., Morkhov K.Y., Nechushkina V.M., Tjulandin S.A. RETROSPECTIVE ANALYSIS OF LONG-TERM SURVIVAL OUTCOMES OF PRIMARY CYTOREDUCTION AND NEOADJUVANT CHEMOTHERAPY IN PATIENTS WITH OVARIAN CANCER STAGE IIIC–IV. Malignant tumours. 2018;8(3):86-94. (In Russ.) https://doi.org/10.18027/2224-5057-2018-8-3-86-94