Survival outcomes of patients with advanced ovarian cancer receiving more than three cycles of neoadjuvant chemotherapy followed by interval cytoreductive surgery

BACKGROUND: The objective of this study was to describe survival outcomes in patients with advanced ovarian cancer according to the number of neoadjuvant chemotherapy (NACT) cycles received and to explore their relation to cytoreduction and pathological response. MATERIALS AND METHODS: The study included 70 patients with advanced ovarian cancers presented to our center receiving neoadjuvant chemotherapy followed by interval debulking surgery and continuation of adjuvant treatment. Files of these patients were reviewed and data were extracted. Patients’ outcomes were determined in terms of progression free survival (PFS) and overall survival (OS). RESULTS: The median age was 59 years. Median PFS and OS was 33 months. Univariate PFS and OS analysis revealed that optimal cytoreduction and achieving pathological complete response (PCR) significantly reduced the hazard of progression and death. However, the time interval between the end of NACT and surgical debulking and the number of adjuvant chemotherapy cycles received didn’t affect the PFS or OS significantly. In multivariate analysis of PFS and OS, it was found that achieving PCR significantly affect the survival outcomes and is considered as independent prognostic and predictive factor for PFS and OS. The rate of optimal cytoreduction was significantly correlated with the number of NACTx cycles received. CONCLUSIONS: Our study suggests that increased number of neoadjuvant chemotherapy cycles in patients with advanced ovarian cancer don’t adversely affect the survival outcomes and that the rate of optimal cytoreduction and achieving PCR significantly affect patients’ survival outcomes. Rate of optimal cytoreduction significantly increased with the increased number of neoadjuvant chemotherapy received.