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abstract
A preoperative low cancer antigen 125 level (≤25.8 mg/dl) is a useful criterion to determine the optimal timing of interval debulking surgery following neoadjuvant chemotherapy in epithelial ovarian cancer
Objective The purpose of this study is to investigate the clinical characteristics to determine the optimal timing of interval debulking
surgery following neoadjuvant chemotherapy in patients with advanced epithelial ovarian cancer.
Methods We reviewed
the charts of women with advanced epithelial ovarian cancer, fallopian
tube cancer or primary peritoneal cancer
who underwent interval debulking surgery
following neoadjuvant chemotherapy at our cancer center (Japan) from April 2006
to April
2014.
Results There were 139
patients, including 91 with ovarian cancer [International Federation of
Gynecology and Obstetrics (FIGO) Stage
IIIc in 56 and IV in 35], two with fallopian
tube cancers (FIGO Stage IV, both) and 46 with primary peritoneal cancer
(FIGO
Stage IIIc in 27 and IV in 19). After 3–6 cycles
(median, 4 cycles) of platinum-based chemotherapy, interval debulking
surgery
was performed.
Sixty-seven patients (48.2%)
achieved complete resection of all macroscopic disease, while 72 did
not. More
patients with cancer antigen 125 levels ≤25.8
mg/dl at pre-interval debulking surgery achieved complete resection than
those
with higher cancer antigen 125 levels (84.7 vs.
21.3%; P< 0.0001). Patients with no ascites at pre-interval debulking surgery also achieved a higher complete resection rate (63.5
vs. 34.1%; P< 0.0001). Moreover,
most patients (86.7%) with cancer antigen 125 levels ≤25.8 mg/dl and no
ascites at pre-interval debulking
surgery achieved complete resection.
Conclusions A low
cancer antigen 125 level of ≤25.8 mg/dl and the absence of ascites at
pre-interval debulking surgery are major predictive
factors for complete resection during interval
debulking surgery and present useful criteria to determine the optimal
timing
of interval debulking surgery.
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