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

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.