Introduction/Background In advanced epithelial ovarian cancer (AEOC) patients with unresectable disease in initial presentation neoadjuvant chemotherapy followed by interval cytoreduction is beneficial in improving patient survival. Cytoreductive surgery including extensive upper abdominal surgery although essential in attaining optimal cytoreduction(OCR) leads to increased post operative morbidity. The aim of our study was to assess the survival outcome and post operative morbidity in patients who underwent interval cytoreductive surgery for AEOC.
Methodology During the time period from January 2014 to September 2018, 415 patients with AEOC were treated in our centre. Patients found to have unresectable disease in initial assessment by CT scan or diagnostic laparoscopy underwent neoadjuvant chemotherapy followed by interval cytoreduction. In this retrospective audit the following parameters were assessed - age at diagnosis, histologic type and grade, medical comorbidities, surgical procedures performed size of residual disease, intra operative complications and post-operative morbidity within 30 days of surgery. Post-operative complications were graded according to the Clavin Dindo grading. Patients were followed up till December 2018. Morbidity profile was assessed using descriptive statistics and Chi-square test for statistical significance. Overall and disease free survival was calculated using Kaplan-Meier method and log-rank test for statistical significance.
Results Median follow up period was 21 months and median age of patients was 55 years. Study included 273 patients of which 80.58% had in Stage III and 19.42% had stage IV disease. OCR could be achieved in 85% (212 patients). Overall survival was 72.3% at the end of 3 years and progression free survival (PFR) was 36.6% at 3 years. PFS was significantly higher in patients who attained OCR (P-0.014). Post-operative surgical morbidity was seen in 33 patients (12.08%).
Conclusion Interval cytoreductive surgeries following neoadjuvant chemotherapy is feasible in AEOC with good rates of optimal cytoreduction and acceptable morbidity.
Disclosure Nothing to disclose.
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