Debulking Surgery Should Come Soon After NACT in Ovarian Cancer

The study covered in this summary was published on researchsquare.com as a preprint and has not yet been peer reviewed.

Key Takeaway

  • Survival outcomes for patients with high-grade serous ovarian carcinoma may be better when interval debulking surgery is performed within a month of neoadjuvant chemotherapy (NACT).

Why This Matters

  • Interval debulking surgery following NACT has gained ground in the treatment of high-grade serous ovarian carcinoma.

  • But whether there is an optimal time interval between the last dose of NACT and interval debulking surgery for patients with high-grade serous ovarian carcinoma remains unclear.

  • The current study demonstrated that performing interval debulking surgery within 4 weeks of NACT may be associated with significantly better overall survival.

Study Design

  • The team reviewed survival outcomes for 115 women with stage IIIC/IV high-grade serous ovarian carcinoma who received NACT before undergoing interval debulking.

  • The authors correlated survival outcomes with the timing of surgery.

Key Results

  • Median progression-free survival was 26.6 months for women who had surgery within a month of NACT, vs 14.4 months for women who had surgery later (P = .004).

  • Median overall survival was 66.3 months among patients who had surgery within a month of NACT completion, vs 39.4 months for those who had surgery later (P = .002).

  • On multivariate analysis, surgery within a month of NACT was an independent predictor of both progression-free survival (hazard ratio [HR], 2.33) and overall survival (HR, 3.23).

  • The results appeared to be independent of tumor biology, given that patients with BRCA1/2 mutations were distributed equally between the groups.

Limitations

  • This was a retrospective, single-institution study with a relatively small number of participants.

  • BRCA1/2 testing was not standard practice at the start of the study period and was not included in the multivariate analysis.

Disclosures

  • No external funding for the study was reported.

  • Several authors reported ties to pharmaceutical companies, including Roche, AstraZeneca, and Merck.

This is a summary of a preprint research study, “Optimal Time Interval Between Neoadjuvant Platinum-based Chemotherapy and Interval Debulking Surgery in High-grade Serous Ovarian Cancer,” led by Angeliki Andrikopoulou of the National and Kapodistrian University of Athens, Greece, provided to you by Medscape. The study has not been peer reviewed. The full text can be found at researchsquare.com.

M. Alexander Otto is a physician assistant with a master’s degree in medical science and a journalism degree from Newhouse. He is an award-winning medical journalist who has worked for several major news outlets before joining Medscape and also an MIT Knight Science Journalism fellow. Email: [email protected].

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