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Ovarian cancer
2022-RA-1607-ESGO Optimal time interval between neoadjuvant platinum-based chemotherapy and interval debulking surgery
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  1. Angeliki Andrikopoulou1,
  2. Kleoniki Apostolidou1,
  3. Charalampos Theofanakis2,
  4. Christos Markellos1,
  5. Efthymia Skafida1,
  6. Oraianthi Fiste1,
  7. Maria Kaparelou1,
  8. Konstantinos Koutsoukos1,
  9. Nikolaos Thomakos2,
  10. Dimitrios Haidopoulos2,
  11. Alexandros Rodolakis2,
  12. Flora Zagouri1,
  13. Meletios-Athanasios Dimopoulos1 and
  14. Michalis Liontos1
  1. 1Department of Oncology, National and Kapodistrian University of Athens, Athens, Greece
  2. 21st Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Athens, Greece

Abstract

Introduction/Background There is limited data on the optimal time interval between the last dose of neoadjuvant chemotherapy (NACT) and interval debulking surgery (IDS) in high-grade serous ovarian carcinoma (HGSC).

Methodology We retrospectively identified patients with stage IIIC/IV HGSC who had received NACT followed by IDS during a 15-year period (January 2003-December 2018) in the Oncology Department of Alexandra University Hospital that were further divided in two groups: the short (<4 weeks) and long (>4 weeks) interval groups.

Results Overall, 115 patients with HGSC stage IIIC/IV that underwent NACT and IDS were included in our analysis. Median age of diagnosis was 62.7 years (SD: 10.7; 39–86). Median PFS was 15.7 months (SD: 1.4; 95% CI: 12.9 – 18.4) and median OS was 44.65 (SD: 2.9; 95% CI: 38.8 – 50.5). Patients were categorized in groups according to interval from NACT to IDS (< 4 weeks (group A); 4 -5 weeks (group B); 5- 6 weeks (group C); >6 weeks (group D). Long time interval from IDS to NACT (> 4 weeks) correlated to poorer PFS (p= 0.006) and OS (p= 0.006). Median PFS was 26.6 months (95% CI: 24 – 29.2) for patients undergoing IDS < 4 weeks after NACT versus 14.4 months (95% CI: 12.6 – 16.2) for the > 4 weeks group (p= 0.006). Median OS was 69.5 months (95% CI: 46.9 – 92.1) versus 38.7 months (95% CI: 31.1 – 46.2) respectively (p= 0.006). On multivariate analysis, interval from NACT to IDS (< 4 weeks vs > 4 weeks) retained its statistical significance in terms of PFS (p= 0.004) and OS (p= 0.002) along with optimal debulking, performance status and administration of bevacizumab (all p< 0.05).

Abstract 2022-RA-1607-ESGO Figure 1
Abstract 2022-RA-1607-ESGO Figure 1
Abstract 2022-RA-1607-ESGO Figure 2
Abstract 2022-RA-1607-ESGO Figure 2

Conclusion We have demonstrated that performing IDS within four weeks after NACT may be associated with better survival outcomes.

https://doi.org/10.1136/ijgc-2022-ESGO.755

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