Dhiman Pravesh, Bapsy P P, Patil C N, Raghupathi Renu
Medical Oncology, Department of RT and Oncology, IGMC, Shimla, Himachal Pradesh, India.
Medical Oncology, Department of Medical Oncology, Apollo Hospitals, Bangalore, Karnataka, India.
South Asian J Cancer. 2022 Dec 30;11(3):207-212. doi: 10.1055/s-0042-1755291. eCollection 2022 Jul.
Pravesh Dhiman, DNB (Medical Oncology). Epithelial ovarian cancer (EOC) is one of the leading causes of cancer-related death in women. Approximately 70% of patients with EOC are diagnosed in advanced stage [The International Federation of Gynecology and Obstetrics(FIGO stage III and IV)] with an expected 5-year survival rate of 30%. Numerous studies have shown that survival with neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) is noninferior to primary debulking surgery followed by chemotherapy. In this retroprospective observational study, 50 patients with advanced ovarian cancer, diagnosed from January 2012 to January 2015, were included and followed-up till January 2017. Correlation of NACT with patient profile, CA125 levels, clinicopathologic parameters, progression-free survival (PFS), and treatment response was studied. Statistical analysis was performed using log-rank test and Kaplan-Meir survival plots. The extent of cytoreduction significantly correlated with PFS. The PFS was maximum in patients who had optimal cytoreduction (19 months) and 10 months in patients with suboptimal cytoreduction with -value < 0.05. The survival was not significantly correlated with other parameters such as age, stage, preoperative CA125 levels, and ascites. The extent of cytoreduction following NACT in this study was associated with statistically significant PFS advantage in patients who were able to undergo optimal cytoreduction, but not significantly correlated to other factors such as age, stage, preoperative CA125 levels, and ascites. NACT followed by interval cytoreduction is an important modality affecting survival in advanced EOC. Further studies and longer follow-up are needed to demonstrate survival advantage over standard treatment.
普拉维什·迪曼，医学肿瘤学医学博士。上皮性卵巢癌（EOC）是女性癌症相关死亡的主要原因之一。约70%的EOC患者在晚期（国际妇产科联盟（FIGO）III期和IV期）被诊断出来，预期5年生存率为30%。众多研究表明，新辅助化疗（NACT）后行间隔减瘤手术（IDS）的生存率不低于先行初次减瘤手术再化疗的生存率。
在这项回顾性观察研究中，纳入了2012年1月至2015年1月期间诊断为晚期卵巢癌的50例患者，并随访至2017年1月。研究了NACT与患者特征、CA125水平、临床病理参数、无进展生存期（PFS）和治疗反应之间的相关性。采用对数秩检验和Kaplan-Meir生存曲线进行统计分析。
减瘤程度与PFS显著相关。达到最佳减瘤效果的患者PFS最长（19个月），减瘤效果欠佳的患者PFS为10个月，P值<0.05。生存率与年龄、分期、术前CA125水平和腹水等其他参数无显著相关性。
本研究中，NACT后的减瘤程度在能够实现最佳减瘤的患者中与具有统计学意义的PFS优势相关，但与年龄、分期、术前CA125水平和腹水等其他因素无显著相关性。NACT后行间隔减瘤是影响晚期EOC患者生存的重要方式。需要进一步研究和更长时间的随访来证明其相对于标准治疗的生存优势。
