2Department of Medical Oncology, Gazi Osman Paşa University Faculty of Medicine, Tokat-Türkiye
3Department of Medical Oncology, Fethi Sekin State Hospital, Elazığ-Türkiye
4Department of Medical Oncology, Dr. Lütfi Kırdar Kartal Training and Research Hospital, İstanbul-Türkiye
5Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara-Türkiye
6Department of Gynecologic Oncology, Hacettepe University Faculty of Medicine, Ankara-Türkiye
7Department of Gynecologic Oncology, Ankara Training and Research Hospital, Ankara-Türkiye
8Department of Medical Oncology, Kırşehir Training and Research Hospital, Kırşehir-Türkiye
9Department of Medical Oncology, University of Health Sciences, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara-Türkiye
10Department of Medical Oncology, Gazi University Faculty of Medicine, Ankara-Türkiye
11Department of Gynecologic Oncology, Gazi University Faculty of Medicine, Ankara-Türkiye
12Department of Medical Oncology, Aydın Atatürk State Hospital, Aydın-Türkiye
13Department of Gynecologic Oncology, Medical Park Hospital, Gaziantep-Türkiye DOI : 10.5505/tjo.2023.3883 OBJECTIVE
The aim of the study is to compare treatment outcomes of the patients with federation of gynecology and obstetrics stages III and IV ovarian carcinomas, who underwent interval debulking surgery after neoadjuvant chemotherapy (NACT), and patients who underwent adjuvant chemotherapy after primary debulking surgery (PDS).
METHODS
Patients from four centers (n=183) were retrospectively evaluated. Of the patients, 91 (50%) were in the
PDS group and 92 (50%) in the NACT group.
RESULTS
In the NACT group patients have advanced age, poor performance status, high levels of CA125, and advanced
disease stage compared with the PDS group (p<0.050). Of the patients receiving NACT, 14 (15%) had a complete response, and 68 (74%) had a partial response. The R0 rate was higher in the PDS group
(p=0.018). In univariate analysis, poor prognostic factors affecting OS were NACT in the treatment
protocol (p<0.001), poor performance status (p<0.001), advanced age (<70 vs. ?70, p=0.002), advanced
clinical stage (p=0.042), and localization of the tumor with the largest diameter outside the omentum
and ovary at the time of diagnosis (p=0.029). In the multivariate analysis, the presence of NACT (HR:
2.30, 95% CI: 1.25?4.23, p=0.007) and poor performance (HR: 2.52, 95% CI: 1.18?5.10, p=0.017) were
independent poor prognostic factors for OS.
CONCLUSION
In the study, OS was better in the PDS group than in the NACT group. This result was thought to be
associated with the NACT group having more disadvantageous characteristics (advanced age, poor performance,
high CA125 level, advanced stage, etc.).