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Neoadjuvant chemotherapy followed by interval debulking surgery for advanced epithelial ovarian cancer: GOTIC-019 study |
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| Authors: | Nagao Shoji Tamura Jun Shibutani Takashi Miwa Maiko Kato Tomoyasu Shikama Ayumi Takei Yuji Kamiya Natsuko Inoue Naoki Nakamura Kazuto Inoue Aya Yamamoto Koji Fujiwara Keiichi Suzuki Mitsuaki |
| Affiliation: | 1.Department of Obstetrics and Gynecology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, Japan ;2.Department of Biostatistics, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Japan ;3.Department of Gynecologic Oncology, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi, Hyogo, 673-8558, Japan ;4.Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Yamane, Hidaka, 1397-1, Japan ;5.Department of Gynecologic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan ;6.Department of Obstetrics and Gynecology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Japan ;7.Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Japan ;8.Department of Obstetrics and Gynecology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Japan ;9.Department of Obstetrics and Gynecology, Gunma University, 3-39-15 Showa-cho, Maebashi, Japan ;10.Department of Gynecologic Oncology, Gunma Prefectural Cancer Center, 617-1 Takabayashi-cho, Ota, Japan ;11.Department of Obstetrics and Gynecology, Ehime University School of Medicine, 454 Shitsukawa, Toon, Japan ;12.Department of Obstetrics and Gynecology, Shin-Yurigaoka General Hospital, 255 Furusawatsuko, Asao-ku, Kawasaki, Japan ; |
| Abstract: | Introduction Three randomized controlled trials have resulted in extremely extensive application of the strategy of using neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS) for patients with advanced epithelial ovarian cancer in Japan. This study aimed to evaluate the status and effectiveness of treatment strategies using NAC followed by IDS in Japanese clinical practice. Patients and methodsWe conducted a multi-institutional observational study of 940 women with Federation of Gynecology and Obstetrics (FIGO) stages III–IV epithelial ovarian cancer treated at one of nine centers between 2010 and 2015. Progression-free survival (PFS) and overall survival (OS) were compared between 486 propensity-score matched participants who underwent NAC followed by IDS and primary debulking surgery (PDS) followed by adjuvant chemotherapy. ResultsPatients with FIGO stage IIIC receiving NAC had a shorter OS (median OS: 48.1 vs. 68.2 months, hazard ratio [HR]: 1.34; 95% confidence interval [CI] 0.99–1.82, p = 0.06) but not PFS (median PFS: 19.7 vs. 19.4 months, HR: 1.02; 95% CI: 0.80–1.31, p = 0.88). However, patients with FIGO stage IV receiving NAC and PDS had comparable PFS (median PFS: 16.6 vs. 14.7 months, HR: 1.07 95% CI: 0.74–1.53, p = 0.73) and OS (median PFS: 45.2 vs. 35.7 months, HR: 0.98; 95% CI: 0.65–1.47, p = 0.93). ConclusionsNAC followed by IDS did not improve survival. In patients with FIGO stage IIIC, NAC may be associated with a shorter OS. |
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