Author(s)

Amen Hamdy Zaky¹, Adel Gabr^1*, Doaa Wadie Maximous², Ahmed A. S. Salem², Amr Farouk Mourad³, Haisam Atta³, Marwa Ismail⁴

¹Medical Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
²Surgical Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
³Radiadiagnosis Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
⁴Clinical Oncology Department, Faculty of Medicine, Assiut University, Assiut, Egypt.

Background: Inappropriately ovarian cancer cannot be detected until an advanced stage. Radical debulking surgery is considered the cornerstone in the management of advanced ovarian cancer pointing to complete tumor resolution. Unless optimal debulking cannot be achieved, these patients gain little benefit from surgery. Neoadjuvant chemotherapy (NACT) has been recommended as a novel therapeutic modality to a diversity of malignant tumors when the disease is not willing to optimal surgical resection at the time of diagnosis or the patient who unfit for aggressive debulking surgery. The purpose of this study is to compare survival in the patient with advanced ovarian cancer (stage III/IV) underwent primary debulking surgery followed by adjuvant chemotherapy (PDS-ACTR) to those who received neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS). Results: Neoadjuvant chemotherapy (NACT-IDS) showed significant complete cytoreduction and decreased in surgical morbidity in comparison to primary debulking surgery (PDS-ACTR). NACT-IDS showed significant improvement in progression-free survival (P-value 0.002) and overall survival (P-value 0.03) in comparison to PDS-ACTR. Response to NACT and residual volume were the two independent prognostic factors for overall survival. Conclusion: NACT-IDS for advanced ovarian cancer (III/IV) resulted in higher frequency of complete resection with no residual tumor, less post-operative surgical morbidity and significant increase progression-free survival and overall survival. Both responses to NACT and residual tumor volume were the two independent prognostic factors for survival in ovarian cancer.

Advanced Ovarian Cancer, Debulking Surgery, Neoadjuvant Chemotherapy

Zaky, A. , Gabr, A. , Maximous, D. , Salem, A. , Mourad, A. , Atta, H. and Ismail, M. (2018) Feasibility of Upfront Debulking Surgery versus Neoadjuvant Chemotherapy Followed by Interval Debulking Surgery for Advanced Ovarian Cancer. Journal of Cancer Therapy, 9, 145-155. doi: 10.4236/jct.2018.92015.