Article Text
Abstract
Objectives Neoadjuvant chemotherapy (NACT) plus interval debulking surgery (IDS) is a treatment strategy for ovarian cancer patients with unresectable disease or poor performance status. It has also used for the treatment of advanced endometrial cancer (ECa) and a survival benefit has been shown. This study reviews our single-institution experience with NACT and surgery for advanced endometrial cancer.
Methods Data were collected retrospectively about patients with ECa treated January 2015-March 2021. Outcome measures include response; survival; and treatment-related morbidity.
Results There were 18 patients aged 39–72yrs. Data is complete for 16 (two had surgery overseas). Histological type was: endometrioid (72%); serous (22%); mixed (6%). 33% were stage IV; 45% stage III; 22% stage II. All patients received Carboplatin/Paclitaxel chemotherapy. Two also received radiotherapy before surgery. Patients received between 2–6 cycles of chemotherapy. Fifteen patients (83.3%) had optimal debulking surgery and one sub-optimal debulking. One patient was lost to follow-up. Another expired before surgery due to septic shock. Data regarding survival is available for 14/18 patients. One has died. Thirteen patients are alive with survival of 6–48mth. Two patients are alive with recurrence. Eleven are alive without recurrence. Overall median survival is currently 20mth. 83% had no significant complications; 11% had wound infection; one patient died from septic shock.
Conclusions NACT and IDS delivers high rates of optimal debulking in patients with advanced stage ECa. There are acceptable levels of morbidity. This study suggests that NACT followed by IDS is at least a non-inferior strategy for patients with advanced ECa who are unsuitable for primary surgery.