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Abstract Background Role of Neoadjuvant chemotherapy in advanced Epithelial Ovarian cancer is evolving, but primary debulking surgery is still the main treatment approach. Aim and Objectives to investigate weather neoadjuvant chemotherapy followed by interval debulking surgery is equal or superior to primary debulking surgery in terms of progression free survival and overall survival in patients with advanced epithelial ovarian cancer. Subjects and Methods we conducted a retrospective study of 50 patients identified with epithelial ovarian cancer stages III &IV in Ain Shams University Hospital from January 2017 to December 2018, and stratified into two treatment groups 1st group was for patients who underwent primary debulking surgery followed by adjuvant chemotherapy, 2nd group was for patients who received neoadjuvant chemotherapy followed by interval debulking surgery, And followed them up to 3 years. Results out of 50 patients included in the study 36 patients (72%) underwent PDS followed by adjuvant chemotherapy, while 14 patients (28%) received neoadjuvant chemotherapy followed by IDS, among the PDS group, the median PFS time in months was 18 month, 95% CI(13.2-22.7) and for neoadjuvant chemotherapy group was 25 month 95% CI (16-52), this difference was not statistically significant, Log Rank test. P value = 0.373, the three year progression free survival was 32% among the studied population, and rates were, respectively, 27.8% and 42.9% in primary debulking and neoadjuvant group. Among primary debulking group the mean survival time in months was 32.6 month, 95% CI(30.2-34.7) and for neoadjuvant chemotherapy group was 30.26 month 95% CI (25.28-35.25), this difference was not statistically significant, Log Rank test. P value = 0.0.768. The three year overall survival rate among the studied group was 74.4%, and rates were, respectively, 75% and 73.3% in PDS and NAC group. Out of all sociodemographic and clinical characteristics of the patients included, Our study demonstrated 2 independent prognostic factors which are optimal debulking surgery and surprisingly positive family history. Conclusion our study demonstrated that neoadjuvant chemotherapy followed by interval debulking surgery provides equal survival compared with primary debulking surgery followed by adjuvant chemotherapy, NAC is a very considerable option to treat advanced EOC for selected cases in which surgery is infeasible or has very high risk morbidity and mortality.
Azmi et al. (Sat,) studied this question.