Vol 5, No 3 (2020)
Original article
Published online: 2020-07-06

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The interval between the primary cytoreductive surgery and adjuvant chemotherapy in patients with advanced ovarian cancer

Sergiі Chetverikov1, Svitlana Zavoloka1, Mykhailo Chetverikov1, Valeriia Chetverikova-Ovchynnyk1
Medical Research Journal 2020;5(3):141-147.

Abstract

Aim of the study was to establish the effect of the time interval between the initial optimal cytoreductive surgery and the initiation of adjuvant chemotherapeutic treatment (ACT) on the overall survival (OS) of patients with advanced ovarian adenocarcinoma.

Materials and methods.
Clinical cases of 60 patients with advanced ovarian adenocarcinoma (FIGO IIIC-IV), with the average age of 61 years, who underwent primary cytoreductive surgery (PDS) with the completeness of cytoreduction (CC) — 0 score according to Shugarbaker and adjuvant chemotherapeutic treatment according to the standard first-line regimen were examined. Patients were categorized depending on the time between surgery and chemotherapeutic treatment into two groups: I — delay of chemotherapy for no more than one month (30 patients), II — from two to six months (30 patients). The OS data of the patients obtained from the national cancer registry were analyzed.

Results.
The results demonstrate an increase in OS of patients who underwent CC-0 PDS at the early initiation of ACT.

Conclusions.
Delaying the onset of ACT is an independent predictor of the worse OS after performing PDS. According to the data obtained, patients should start ACT within 1 month after the surgery. However, the findings are proved if CC-0 is achieved during the operation.

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References

  1. Martinez A, Ngo C, Leblanc E, et al. Surgical Complexity Impact on Survival After Complete Cytoreductive Surgery for Advanced Ovarian Cancer. Ann Surg Oncol. 2016; 23(8): 2515–2521.
  2. Xu X, Deng F, Lv M, et al. The number of cycles of neoadjuvant chemotherapy is associated with prognosis of stage IIIc-IV high-grade serous ovarian cancer. Arch Gynecol Obstet. 2017; 295(2): 451–458.
  3. Xiao Y, Xie S, Zhang N, et al. Platinum-Based Neoadjuvant Chemotherapy versus Primary Surgery in Ovarian Carcinoma International Federation of Gynecology and Obstetrics Stages IIIc and IV: A Systematic Review and Meta-Analysis. Gynecol Obstet Invest. 2018; 83(3): 209–219.
  4. Kobal B, Noventa M, Cvjeticanin B, et al. Primary debulking surgery versus primary neoadjuvant chemotherapy for high grade advanced stage ovarian cancer: comparison of survivals. Radiol Oncol. 2018; 52(3): 307–319.
  5. Somashekhar SP. Does debulking of enlarged positive lymph nodes improve survival in different gynaecological cancers? Best Pract Res Clin Obstet Gynaecol. 2015; 29(6): 870–883.
  6. Sinukumar S, Rajan F, Mehta S, et al. A comparison of outcomes following total and selective peritonectomy performed at the time of interval cytoreductive surgery for advanced serous epithelial ovarian, fallopian tube and primary peritoneal cancer - A study by INDEPSO. Eur J Surg Oncol. 2019 [Epub ahead of print].
  7. Zhang G, Zhu Y, Liu C, et al. The prognosis impact of hyperthermic intraperitoneal chemotherapy (HIPEC) plus cytoreductive surgery (CRS) in advanced ovarian cancer: the meta-analysis. J Ovarian Res. 2019; 12(1): 33.
  8. Le Saux O, Decullier E, Freyer G, et al. Long-term survival in patients with epithelial ovarian cancer following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). Int J Hyperthermia. 2018; 35(1): 652–657.
  9. Tewari KS, Java JJ, Eskander RN, et al. Early initiation of chemotherapy following complete resection of advanced ovarian cancer associated with improved survival: NRG Oncology/Gynecologic Oncology Group study. Ann Oncol. 2016; 27(1): 114–121.
  10. Timmermans M, van der Aa MA, Lalisang RI, et al. Interval between debulking surgery and adjuvant chemotherapy is associated with overall survival in patients with advanced ovarian cancer. Gynecol Oncol. 2018; 150(3): 446–450.
  11. Seagle BLL, Butler SK, Strohl AE, et al. Chemotherapy delay after primary debulking surgery for ovarian cancer. Gynecol Oncol. 2017; 144(2): 260–265.
  12. Joseph N, Clark RM, Dizon DS, et al. Delay in chemotherapy administration impacts survival in elderly patients with epithelial ovarian cancer. Gynecol Oncol. 2015; 137(3): 401–405.
  13. Liu Yi, Zhang T, Wu Q, et al. Relationship between initiation time of adjuvant chemotherapy and survival in ovarian cancer patients: a dose-response meta-analysis of cohort studies. Sci Rep. 2017; 7(1): 9461.
  14. Lee YY, Lee JW, Lu L, et al. Impact of interval from primary cytoreductive surgery to initiation of adjuvant chemotherapy in advanced epithelial ovarian cancer. Int J Gynaecol Obstet. 2018; 143(3): 325–332.
  15. Starbuck KD, Szender JB, Duncan WD, et al. Prognostic impact of adjuvant chemotherapy treatment intensity for ovarian cancer. PLoS One. 2018; 13(11): e0206913.
  16. Olawaiye AB, Java JJ, Krivak TC, et al. Does adjuvant chemotherapy dose modification have an impact on the outcome of patients diagnosed with advanced stage ovarian cancer? An NRG Oncology/Gynecologic Oncology Group study. Gynecol Oncol. 2018; 151(1): 18–23.
  17. Garcia-Soto AE, Java JJ, Nieves Neira W, et al. Does time interval between surgery and intraperitoneal chemotherapy administration in advanced ovarian cancer carry a prognostic impact? An NRG Oncology/Gynecologic Oncology Group study ancillary study. Gynecol Oncol. 2016; 143(3): 484–489.
  18. Lee YJ, Chung YS, Lee JY, et al. Impact of the time interval from completion of neoadjuvant chemotherapy to initiation of postoperative adjuvant chemotherapy on the survival of patients with advanced ovarian cancer. Gynecol Oncol. 2018; 148(1): 62–67.
  19. Chen M, Chen Z, Xu M, et al. Impact of the Time Interval from Neoadjuvant Chemotherapy to Surgery in Primary Ovarian, Tubal, and Peritoneal Cancer Patients. J Cancer. 2018; 9(21): 4087–4091.
  20. Jeong SY, Choi CH, Kim TJ, et al. Interval between secondary cytoreductive surgery and adjuvant chemotherapy is not associated with survivals in patients with recurrent ovarian cancer. J Ovarian Res. 2019; 13(1): 1.