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Abstract
Introduction/Background ESMO ESGO guidelines recommend standard 3–4 cycles of neoadjuvant chemotherapy (NACT) for advanced epithelial ovarian cancers (EOC). Covid pandemic saw several oncosurgeries postponed due to healthcare crisis. Present study was undertaken to evaluate oncological outcomes in patients undergoing delayed cytoreductive surgery (CRS) in advanced Epithelial Ovarian Cancer.
Methodology This was a hospital based, retrospective, observational study done at Dr B Borooah Cancer Institute, Guwahati, India between January 2019 to December 2021. Objectives were to evaluate disease free survival (DFS) and overall survival (OS) according to timing of surgery and to identify prognostic factors for OS and PFS. Study group included patients undergoing Delayed CRS (defined as CRS done after more than 5 cycles of NACT), and control group comprised of CRS done after 3–4 cycles NACT.
Results Total 28 patients underwent delayed CRS, of these 58% (n=16) patients had Covid related causes for delay in surgery and 42%(n=12) had inoperable disease after 3/4 cycles. Similarly complete chemotherapy response score was observed in lower proportion in delayed CRS (24.13% vs 28.15%, p=0.003). On comparing the delayed CRS due to COVID with that due to poor responders (inoperable disease), the two groups did not have statistically significant survival outcomes, OS(p=0.8) & DFS(p=0.6). The delayed CRS group due to COVID had a decreased overall survival as compared to control group (n=103) (figure 1). The log-rank test suggests that the survival in the two groups leans towards better survival in control group (p=0.05).
Conclusion Administration of additional cycles of chemotherapy beyond 3–4 cycles in the COVID group seemed to decrease the OS in these patients, however Delayed CRS is a viable option for patients who may be deemed inoperable after 3–4 cycles of NACT. In view of small size and retrospective nature, further prospective study is needed.
Overall Survival analysis of patients undergoing delayed CRS due to Covid versus control group
Disclosures None to declare.