Article Text
Abstract
Introduction Assessing tumor response in advanced ovarian cancer guides treatment decisions; RECIST 1.1, CA125 reduction, and clinical examination are essential but not always conclusive. We aim to pinpoint risk factors predicting discordant response assessment to neoadjuvant chemotherapy (NACT) in advanced epithelial ovarian cancer (EOC) patients.
Methods A retrospective study conducted at Salah Azaiez Institute of Oncology from 2017 to 2022 assessed response consistency to neoadjuvant chemotherapy (NACT) in advanced EOC patients.
Results Sixty-six patients underwent interval debulking surgery after NACT for advanced ovarian cancer, stage IIIC, and IV; in 24 patients (36,36%), the pre-debulking assessment was found inconsistent with per operative findings, and in 42 patients (63,63%), the data of CT scan was coherent. Patients undergoing interval debulking surgery (IDS) within 45 days of CT scan evaluation had a higher consistent response assessment (66.7%) compared to those undergoing surgery after 45 days (33.3%) (p=0.09). IDS performed after six weeks of NACT showed a higher tendency towards inconsistent response assessment (75%) compared to surgery before six weeks (25%) (p=0.06). Patients with post-NACT CA125 levels < 100 U/mL exhibited a consistent response assessment in 81% of cases, while those with CA125 levels > 100 U/mL had an inconsistent evaluation in 60% of cases, showing significant differences (p=0.05).
Conclusion/Implications In the literature, limited publications address inconsistent chemotherapy responses in advanced ovarian cancer. Our study identifies three risk factors linked to disparities between pre-debulking assessment and preoperative findings. Nonetheless, additional studies with large samples are warranted to corroborate these results due to our small sample size.