Does neoadjuvant chemotherapy impair long-term survival for ovarian cancer patients? A nationwide Danish study

Research output: Contribution to journalJournal articlepeer-review

  • Carsten Lindberg Fagö-Olsen
  • Bent Ottesen
  • Kehlet, Henrik
  • Sofie L Antonsen
  • Ib J Christensen
  • Algirdas Markauskas
  • Berit J Mosgaard
  • Christian Ottosen
  • Charlotte H Soegaard
  • Erik Soegaard-Andersen
  • Høgdall, Claus Kim

OBJECTIVE: In Denmark, the proportion of women with ovarian cancer treated with neoadjuvant chemotherapy (NACT) has increased, and the use of NACT varies among center hospitals. We aimed to evaluate the impact of first-line treatment on surgical outcome and median overall survival (MOS).

METHODS: All patients treated in Danish referral centers with stage IIIC or IV epithelial ovarian cancer from January 2005 to October 2011 were included. Data were obtained from the Danish Gynecological Cancer Database, the Danish National Patient Register and medical records.

RESULTS: Of the 1677 eligible patients, 990 (59%) were treated with primary debulking surgery (PDS), 515 (31%) with NACT, and 172 (10%) received palliative treatment. Of the patients referred to NACT, 335 (65%) received interval debulking surgery (IDS). Patients treated with NACT-IDS had shorter operation times, less blood loss, less extensive surgery, fewer intraoperative complications and a lower frequency of residual tumor (p < 0.05 for all). No difference in MOS was found between patients treated with PDS (31.9 months) and patients treated with NACT-IDS (29.4 months), p = 0.099. Patients without residual tumor after surgery had better MOS when treated with PDS compared with NACT-IDS (55.5 and 36.7 months, respectively, p = 0.002). In a multivariate analysis, NACT-IDS was associated with increased risk of death after two years of follow-up (HR: 1.81; CI: 1.39-2.35).

CONCLUSIONS: No difference in MOS was observed between PDS and NACT-IDS. However, patients without residual tumor had superior MOS when treated with PDS, and NACT-IDS could be associated with increased risk of death after two years of follow-up.

Original languageEnglish
JournalGynecologic Oncology
Volume132
Issue number2
Pages (from-to)292-298
Number of pages7
ISSN0090-8258
DOIs
Publication statusPublished - Feb 2014

    Research areas

  • Aged, Chemotherapy, Adjuvant, Cohort Studies, Denmark, Female, Humans, Middle Aged, Neoadjuvant Therapy, Neoplasm Staging, Neoplasms, Glandular and Epithelial, Ovarian Neoplasms, Retrospective Studies, Survivors, Treatment Outcome

ID: 138314003