In:
Journal of Surgical Oncology, Wiley, Vol. 120, No. 4 ( 2019-09), p. 779-785
Abstract:
Background: We sought to determine if complete pathologic response (cPR) and cytoreductive status at interval debulking surgery (IDS) after neoadjuvant chemotherapy (NACT) are associated with improved clinical outcomes in ovarian cancer. Methods: We evaluated 91 patients with advanced ovarian cancer who underwent NACT and IDS. Pathologic response, cytoreductive status, and outcomes were determined. Descriptive statistics, bivariate analysis, and Kaplan‐Meier survival probabilities were calculated. Results: cPR occurred in 9 (10%), microscopic pathologic response (microPR) in 18 (20%), and macroscopic pathologic response (macroPR) in 64 (70%) patients. Median progression‐free survival (PFS) for patients with cPR was significantly improved compared with patients with any pathologic residual disease (microPR/macroPR; undefined vs 10.9 months, P = .01); whereas, microPR was not associated with significantly improved PFS compared with macroPR (16.3 months vs 10 months, P = .08). Cytoreduction to no gross residual disease was associated with improved PFS (undefined vs 7.5 months vs 5.5 months, P 〈 .01) and overall survival (undefined vs 38.7 months vs 12 months, P 〈 .01) compared with visible residual disease less than or equal to 1 cm or suboptimal. Conclusions: cPR is uncommon (10%) after NACT for advanced ovarian cancer. Better pathologic response and cytoreductive status are associated with improved PFS, emphasizing the importance of both chemotherapy response and surgical effort.
Type of Medium:
Online Resource
ISSN:
0022-4790
,
1096-9098
Language:
English
Publisher:
Wiley
Publication Date:
2019
detail.hit.zdb_id:
1475314-5
Bookmarklink
