Outcome of patients with advanced ovarian cancer who do not undergo debulking surgery: A single institution retrospective review Ovarian Cancer and Us OVARIAN CANCER and US Ovarian Cancer and Us

Blog Archives: Nov 2004 - present

#ovariancancers



Special items: Ovarian Cancer and Us blog best viewed in Firefox

Search This Blog

Thursday, November 10, 2016

Outcome of patients with advanced ovarian cancer who do not undergo debulking surgery: A single institution retrospective review



abstract
 (IDS = interval debulking surgery) 

Highlights

  • Debulking surgery is not feasible for up to 20% of patients.
  • Chemotherapy alone can allow reasonable disease control in women unsuitable for IDS.
  • Carboplatin plus paclitaxel should be used when possible.

Objective

To assess the outcome of patients with advanced ovarian cancer (OC) who were treated without surgery, having received upfront chemotherapy and no interval debulking surgery (IDS).

Methods

Retrospective analysis of medical and chemotherapy records of consecutive patients with OC between 2005 and 2013 at UCL Hospitals London, UK who received neoadjuvant chemotherapy (NACT) was then found to be unsuitable for IDS following review by the multidisciplinary team.

Results

Eighty-three patients (18%) out of 467 receiving NACT did not undergo IDS. Median age was 70 years (range 33–88); out of these 83 patients, 43 (51.8%) presented with stage IV disease. Forty-three of these 83 patients received carboplatin and paclitaxel (CP) (51.8%) and 37 received carboplatin alone (C) (44.6%); 3 patients (3.6%) received other platinum-based combinations. Reasons for not proceeding to surgery were: poor response to chemotherapy after 3–4 cycles of NACT (61/83, 73.5%); comorbidities (12/83, 14.5%); patient decision (4/83, 4.8%). Six patients (7.2%) received <3 cycles of NACT due to a worsening clinical condition. The median overall survival (OS) for patients not undergoing IDS was 18 months (95% CI 10–20 months). Forty-four of 83 patients (53%) received >2 lines of chemotherapy. In a univariate analysis CP, age <70 years, and absence of comorbidities were factors influencing OS. In a multivariate analysis only having received CP remained independently associated with OS (HR 0.49, 95% CI 0.29–0.84).

Conclusions

Chemotherapy alone can provide reasonable disease control in patients unsuitable for IDS and CP should be used if possible.

0 comments :

Post a Comment

Your comments?