KEY TAKEAWAYS
- The study aimed to investigate NACT’s impact on complex surgeries required for optimal cytoreduction in advanced epithelial OC.
- Researchers noticed that NACT did not reduce overall complex surgery needs but lessened specific procedures.
Okan Aytekin and the team aimed to evaluate the impact of neoadjuvant chemotherapy (NACT) on the necessity for complex surgical procedures, in addition to staging surgery, to achieve optimal cytoreduction (residual tumor ≤ 1 cm) in patients with stage IIIC-IV epithelial ovarian cancer (OC).
They performed an inclusive analysis of patients with stage IIIC-IV epithelial OC who were referred for NACT. Patients were selected for NACT if preoperative imaging and/or intraoperative evaluation indicated that achieving a residual tumor size of 1 cm or less with primary cytoreductive surgery was not feasible, or if the patients exhibited poor performance status and a high American Society of Anesthesiologists (ASA) score.
The study categorized surgical procedures as complex or non-complex, based on the extent and difficulty of the required interventions.
About 126 patients with stage IIIC-IV OC were included in the study. Primary cytoreductive surgery was performed in 67 patients, while interval cytoreductive surgery was conducted in 59 patients after NACT.
At least 1 complex surgery was performed in 74.6% of the patients in the primary cytoreductive surgery group and in 61% of the patients in the NACT group, with no statistically significant difference observed between the groups. However, the NACT group demonstrated significantly lower rates of low-rectal resection, diaphragmatic peritoneal stripping, and peritonectomy.
The study concluded that NACT did not reduce the overall requirement for at least 1 complex surgical procedure in patients with stage IIIC-IV epithelial OC. However, it was observed that the NACT group had significantly decreased rates of specific procedures such as low-rectal resection, diaphragmatic peritoneal stripping, and peritonectomy, highlighting the effectiveness of NACT in reducing peritoneal disease.
The study received no funds.
Source: https://pubmed.ncbi.nlm.nih.gov/39085835/
Aytekin O, Kerinc SK, Tokalioglu AA, et al. (2024). “Does neoadjuvant chemotherapy reduce surgical complexity in patients with advanced-stage epithelial ovarian cancer?” BMC Womens Health. 2024 Jul 31;24(1):435. doi: 10.1186/s12905-024-03280-z. PMID: 39085835.
