Škof Erik, Merlo Sebastjan, Pilko Gasper, Kobal Borut
Department of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Department of Surgery, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Radiol Oncol. 2016 Jul 19;50(3):341-6. doi: 10.1515/raon-2016-0034. eCollection 2016 Sep 1.
Primary treatment of patients with advanced epithelial ovarian cancer consists of chemotherapy either before (neoadjuvant chemotherapy, NACT) or after primary surgery (adjuvant chemotherapy). The goal of primary treatment is no residual disease after surgery (R0 resection) what is associated with an improvement in survival of patients. There is, however, no evidence of survival benefits in patients with R0 resections after prior NACT.
We retrospectively reviewed the records of patients who were treated with diagnosis of epithelial ovarian cancer at Institute of Oncology Ljubljana in the years 2005-2007. The differences in the rates of R0 resections, progression free survival (PFS), overall survival (OS) and in five-year and eight-year survival rates between patients treated with NACT and patients who had primary surgery were compared.
Overall 160 patients had stage IIIC epithelial ovarian cancer. Eighty patients had NACT and eighty patients had primary surgery. Patients in NACT group had higher rates of R0 resection (42% vs. 20%; p = 0.011) than patients after primary surgery. PFS was 14.1 months in NACT group and 17.7 months after primary surgery (p = 0.213). OS was 24.8 months in NACT group and 31.6 months after primary surgery (p = 0.012). In patients with R0 resections five-year and eight-year survival rates were 20.6% and 17.6% in NACT group compared to 62.5% and 62.5% after primary surgery (p < 0.0001), respectively.
Despite higher rates of R0 resections achieved by NACT, survival of patients treated with NACT was inferior to survival of patients who underwent primary surgery. NACT should only be offered to patients with advanced epithelial cancer who are not candidates for primary surgery.
晚期上皮性卵巢癌患者的初始治疗包括术前化疗（新辅助化疗，NACT）或初次手术后化疗（辅助化疗）。初始治疗的目标是手术后无残留疾病（R0切除），这与患者生存率的提高相关。然而，尚无证据表明先前接受NACT后行R0切除的患者有生存获益。
我们回顾性分析了2005年至2007年在卢布尔雅那肿瘤研究所被诊断为上皮性卵巢癌并接受治疗的患者记录。比较了接受NACT治疗的患者与接受初次手术的患者在R0切除率、无进展生存期（PFS）、总生存期（OS）以及五年和八年生存率方面的差异。
共有160例患者患有IIIC期上皮性卵巢癌。80例患者接受了NACT，80例患者接受了初次手术。NACT组患者的R0切除率（42%对20%；p = 0.011）高于初次手术后的患者。NACT组的PFS为14.1个月，初次手术后为17.7个月（p = 0.213）。NACT组的OS为24.8个月，初次手术后为31.6个月（p = 0.012）。在R0切除的患者中，NACT组的五年和八年生存率分别为20.6%和17.6%，而初次手术后分别为62.5%和62.5%（p < 0.0001）。
尽管NACT实现了更高的R0切除率，但接受NACT治疗的患者生存率低于接受初次手术的患者。NACT仅应提供给不适合初次手术的晚期上皮性癌患者。
