Comparative Retrospective Analysis of Ovarian Cancer Treatment Outcomes: Neoadjuvant Therapy with and without Surgical Intervention.

Abstract

Ovarian cancer, a leading cause of cancer-related mortality among Indian women, is predominantly diagnosed at advanced stages. The efficacy of neoadjuvant chemotherapy (NACT) versus traditional treatment approaches, including surgery, remains a critical area of investigation to improve patient outcomes. This retrospective observational study analyzed 84 patients with advanced ovarian carcinoma (stage IIIC or IV) treated at tertiary care center, Tamil Nadu. It compared survival outcomes between patients receiving NACT alone and those undergoing NACT followed by surgical intervention. Data on demographic characteristics, tumor size, ECOG performance status, menopausal status, ascites fluid cytology, and comorbidities were collected. Kaplan-Meier survival analysis and Cox regression were used for statistical assessment. The study found significant associations between treatment modality and survival outcomes. Tumor size, particularly T3, positive ascitic fluid cytology, and neoadjuvant chemotherapy significantly influenced recurrence risk. The overall survival time had a median of 9 years, and time to recurrence had a median of 8 years. Neoadjuvant chemotherapy, when combined with surgical intervention, demonstrated a potential improvement in survival outcomes. The integration of neoadjuvant chemotherapy with surgical intervention may offer beneficial outcomes for patients with advanced ovarian cancer. This study underscores the importance of tailored treatment approaches, emphasizing the role of NACT in the therapeutic landscape of ovarian cancer.