Neoadjuvant chemotherapy and the complexity of operative procedure in advanced epithelial ovarian cancer: a retrospective analysis

B. Refky, Amr F. Elalfy, H. Nabil, D. El-Emam, K. Abdelwahab, E. Malik, A. Soliman
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Abstract

Introduction: Complete tumor resection for epithelial ovarian cancer (EOC) generally incorporates complex surgical maneuvers, especially bowel resection. This study retrospectively analyzed the impact of neoadjuvant chemotherapy (NAC) on complexity of surgical procedures for EOC (represented by bowel resection) and postoperative morbidity. Methods: We retrospectively recruited all patients with Fédération Internationale de Gynécologie et d'Obstétrique (FIGO) stages IIIC–IVB EOC who were treated in our center between 2011 and 2016. Patients were divided into those who received primary debulking followed by chemotherapy (group A), and those who received NAC followed by interval debulking (group B). Patient age, tumor stage, grade, dates of commencement and completion of therapy, intraoperative events, completion of surgical resection, and postoperative events were evaluated. Results: Of 92 patients, 42 were assigned to group A and 50 to group B. Their FIGO stages were group A—stages IIIC: 34 (80.9%), IVA: 6 (14.3%), and IVB: 2 (4.8%); and group B—stages IIIC: 45 (90%), IVA: 5 (10%), and IVB: 0 (0%). The 2 groups did not significantly differ in completeness of surgical cytoreduction or rates of bowel resection, intraoperative complications, or postoperative morbidities. Conclusion: NAC did not reduce rates of bowel resection, intraoperative complications, and postoperative morbidity in advanced EOC compared with primary surgical cytoreduction. Future prospective studies will be required to corroborate our results.
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晚期上皮性卵巢癌的新辅助化疗与手术复杂性:回顾性分析
上皮性卵巢癌(EOC)的完全肿瘤切除术通常包括复杂的手术操作,特别是肠切除术。本研究回顾性分析了新辅助化疗(NAC)对EOC手术程序复杂性(以肠切除术为代表)和术后发病率的影响。方法:回顾性招募2011年至2016年在我中心治疗的所有患有fidic - iii - ivb期EOC的患者。患者分为先行减容后化疗组(A组)和先行NAC后间歇减容组(B组)。对患者年龄、肿瘤分期、分级、开始和完成治疗的日期、术中事件、手术切除完成和术后事件进行评估。结果:92例患者中,A组42例,b组50例,FIGO分期为A组IIIC: 34例(80.9%),IVA: 6例(14.3%),IVB: 2例(4.8%);b组IIIC: 45例(90%),IVA: 5例(10%),IVB: 0例(0%)。两组在手术细胞减少的完全性、肠切除术的发生率、术中并发症或术后发病率方面没有显著差异。结论:与最初的手术细胞减少术相比,NAC并没有降低晚期EOC的肠切除率、术中并发症和术后发病率。未来的前瞻性研究将需要证实我们的结果。
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