Evaluation of short versus long course chemotherapy in the neoadjuvant setting in ovarian cancer

Abstract

Background: There is a debate about the optimum number of neoadjuvant chemotherapy (NACT) cycles for ovarian cancer and its impact on survival. Objective: This study aimed to assess the optimum number (NACT) cycles that influence the surgical and pathological outcome and its impact on survival. Methods: retrospective cohort study, all patients included were newly diagnosed ovarian cancer who received NACT then underwent interval debulking surgery (IDA), presented to tertiary cancer center from July 2011 to December 2021.patients were classified into two groups according to number of NACT cycles. Group 1; Patients who received ≤ 4 cycles Group 2; Patients who received ≤ 5 cycles. Results: 207 patients were included (130 patients in group 1, 70 patients in group 2). 63.1% of group I were stage III while 51.9% of group II were stage IV. There was no difference between two groups in pathological response to NACT (P = 0.9), or those who underwent optimal cytoreduction (P = 0.8). group 2 received a higher total dose of perioperative chemotherapy (median 8 VS 6 cycles) (P-value < .001). There were no significant differences between both groups regards overall (OS) or relapse free survivals (RFS) (P = 0.5. 0.1 respectively). Conclusion Receiving more than 4 cycles of neoadjuvant chemotherapy followed by cytoreductive surgery had no impact on achievement of optimal cytoreduction surgery or surgical morbidity and mortality and did not affect relapse free or overall survivals.