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  • 94 Histopathological response on clinicoradiological presentation and prognosis of patients with advanced high grade serous ovarian carcinoma treated with neoadjuvant chemotherapy

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E-Poster discussions
Poster Discussion with the Professor Station 4
IGCS19-0307
94 Histopathological response on clinicoradiological presentation and prognosis of patients with advanced high grade serous ovarian carcinoma treated with neoadjuvant chemotherapy
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  1. A Lopes1,
  2. ML Nogueira D Genta2,
  3. V da Costa Miranda3,
  4. RV Mendonza Lopez4,
  5. F Marino Carvalho5 and
  6. J Paula Carvalho2
  1. 1Instituto do Cancer do Estado de São Paulo- Faculdade de Medicina da Universidade de Sao Paulo ICESP-HCFMUSP, Surgery Division- Gastroenterology Department, São Paulo, Brazil
  2. 2Instituto do Cancer do Estado de São Paulo- Faculdade de Medicina da Universidade de Sao Paulo ICESP-HCFMUSP, Gynecology Department, São Paulo, Brazil
  3. 3Instituto do Cancer do Estado de São Paulo- Faculdade de Medicina da Universidade de Sao Paulo ICESP-HCFMUSP, Oncology Department, São Paulo, Brazil
  4. 4Instituto do Cancer do Estado de São Paulo- Faculdade de Medicina da Universidade de Sao Paulo ICESP-HCFMUSP, Department of Biostatistics, São Paulo, Brazil
  5. 5Faculdade de Medicina da Universidade de Sao Paulo, Department of Pathology, Sao Paulo, Brazil

Abstract

Objectives To analyze the influence of histopathological response on clinicoradiological and survival of patients with high-grade serous ovarian carcinoma (HGSC) after neoadjuvant chemotherapy.

Methods From 2008 to 2016, patients with advanced HGSC (FIGO IIIC-IVB) who underwent 6 cycles of NACHT (carboplatin-paclitaxel) followed by cytoreductive surgery were reviewed and divided in 3 groups: complete pathological response (1), pathological residual tumor with complete cytoreduction (2), and sub-optimal cytoreduction (3). CA-125 and computed tomography response were classified by RECIST criteria and compared using Fisher’s exact and McNemar tests, respectively. Progression-free survival (PFS) and overall survival (OS) were analyzed using Cox-proportional hazard.

Results One-hundred-one patients, median age 60 years, followed by median of 36 months, were included. Groups 1 (n=10), 2 (n=61), and 3 (n=31) presented, respectively, mean OS of 75.7 (63–88); 55 (95% CI 41–69), and 26 (95% CI 19–32) months (p = <0.004). The median DFS was 33 (27–66) and 7.7 (6–8) months for groups 1 and 2, respectively. Complete radiological response was seen in 80%, 25% and 3% (p= <0001) while normalization of CA-125 was observed in 100%, 61% and 38% on groups 1, 2 and 3, respectively (p= 0.003). OS among patients with CA-125 normalization (n=62) was higher than among non-responders (61, CI 95% 41–81 months vs. 30, CI95% 23–37 months (p=0.003). Median OS associated with complete, partial and stable/progression radiological response was 79(24–134), 35(26–43) and 30(12–48) months, respectively (p= 0.034).

Conclusions Complete histopathological response, normalization of CA-125 and complete radiological response after NACHT were associated with improved overall and disease free survival.

https://doi.org/10.1136/ijgc-2019-IGCS.94

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