PURPOSE To determine factors and survival of patients with ovarian cancer after primary debulking surgery followed by adjuvant chemotherapy (PDS) versus neoadjuvant chemotherapy followed by interval cytoreduction (NAC). METHODS GOG-262 was a prospective randomized trial evaluating once per week dose dense chemotherapy. The physicians were given the option of performing PDS versus NAC. Chi-squared tests and Kaplan-Meier procedures were used for analyses. RESULTS Of 192 patients from centers offering both treatment options, 119 (62%) patients had PDS and 73 (38%) underwent NAC. Compared with the PDS group, NAC patients were older (60 years and older) age (67% v 47%; P < .01) and had more advanced (stage IV) disease (41.1% v 26.1%, P < .01) and peritoneal versus ovarian or fallopian tube cancers (16.4% v 5.0%, P < .001). The 5-year unadjusted overall survival of patients after NAC was 41.9 versus 47.8 months in the PDS group. After adjusting for prognostic factors, PDS was not an independent predictor for survival (hazard ratio HR, 1.08 95% CI, 0.67 to 1.7; P = .75), whereas more advanced (IV v II/III)-stage (HR, 1.9 95% CI, 0.93 to 3.89; P = .079) and peritoneal versus ovarian or fallopian tube cancers (HR, 4.36 95% CI, 1.45 to 13.1; P = .009) were associated with poorer survival. CONCLUSION Compared with primary surgery followed by chemotherapy, neoadjuvant chemotherapy followed by interval surgery patients were older and had more advanced disease (stage IV v II-III) and more primary peritoneal cancer ( v ovarian and fallopian tube cancer). The survival of these two groups was comparable after adjusting for prognostic factors.
Chan et al. (Wed,) studied this question.