Neoadjuvant chemotherapy combined with laparoscopic cytoreductive surgery in patients with advanced ovarian cancer.

Purpose: To explore the clinical efficacy and safety of neoadjuvant chemotherapy (NACT) combined with minimally invasive laparoscopic cytoreductive surgery in the treatment of patients with advanced ovarian cancer (AOC).

Methods: The clinical data of 116 patients with AOC were divided into NACT group (NACT combined with laparoscopic cytoreductive surgery, n=58) and control group (cytoreductive surgery alone, n=58). The short-term efficacy, surgery-related indexes, incidence of adverse reactions, and changes in levels of serum human epididymis protein 4 (HE4), vascular endothelial growth factor (VEGF) and carbohydrate antigen 125 (CA125) before and after treatment were compared between the two groups. The survival status of patients after treatment was recorded.

Results: The operation time, intraoperative blood loss, ascites volume, postoperative ventilation time, and average postoperative length of hospitalization in NACT group were all significantly shorter and less than those in the control group. The optimal cytoreduction rate in NACT group was far higher than that in the control group. The overall response rate in NACT group was obviously higher than that in the control group. After treatment, the levels of serum HE4, VEGF and CA125 greatly declined in the two groups compared with those before treatment, while they were obviously lower in the NACT group than those in the control group. The follow-up results revealed that the median overall survival (OS) was 31.1 months and 28.9 months, and the 3-year OS rate was 43.1% (25/58) and 31.0% (18/58), respectively, in the NACT group and control group.

Conclusion: NACT can significantly shorten the duration of cytoreductive surgery of AOC, reduce intraoperative blood loss, accelerate postoperative recovery, raise the optimal cytoreduction rate, and enhance the clinical efficacy, without greatly improving the survival of patients.