Clinical Characteristics and 8-year Survival Rate in Advanced Ovarian Cancer Following Neoadjuvant Chemotherapy: A Single Center Experience

Abstract

Background: More than 75% of epithelial ovarian cancer (EOC) cases are diagnosed in advanced stages, which is associated with tumor recurrence and chemotherapy resistance. So far, to the best of our knowledge, a similar study has not been conducted in Iran to investigate the clinical characteristics and survival rate of these patients treated with neoadjuvant chemotherapy (NACT). Objectives: This study aimed to evaluate the clinical characteristics and survival of patients treated with NACT followed by cytoreductive surgery and the factors affecting survival. Methods: This retrospective cohort study was conducted on 147 advanced ovarian cancer cases who were treated with NACT referring to the Gynecology Oncology Department of Imam Khomeini Hospital in Tehran, Iran, between 2011 and 2021 and met the inclusion criteria for this study. The survival curve and Cox regression method were used to analyze the data. Results: The results revealed that 8.9% of advanced EOC (147/1,650) were treated with NACT and the average number of NACT courses was 4.12 periods. The survival rates of 1, 3, 5, and 8 years were 85.31%, 44.05%, 18.35%, and 13.77%, respectively. The mean and median of survival time were 47.7 and 36 months, respectively. Nearly 80% of the patients had stages 3C and 4A before receiving NACT. Based on the results of the adjusted Cox regression model, tumor marker level showed a significant relationship with survival rate (P=0.008), and also peritoneum involvement had a clinically significant impact on survival with a hazard ratio of 2.88. Conclusion: The results suggested that 8.9% of ovarian cancer cases were treated with NACT. It was also revealed that the average number of NACT courses was 4.12 periods and the 8-year survival rate was 13.77%. CA125 tumor marker level showed a significant relationship with survival rate, and peritoneum involvement had a clinically significant impact on survival.