OPTIMISING THE TREATMENT OF PATIENTS WITH ADVANCED OVARIAN CANCER: AN ANALYSIS OF PRELIMINARY RESULTS

Abstract

Summary. Aim: to evaluate surgical complications, side effects of chemotherapy, 1- and 3-year survival in patients with advanced ovarian cancer against the background of the introduction of optimized personalized treatment. Object and methods: for this purpose, a comparative analysis of the results of clinical examination and treatment of 74 patients with primary serous ovarian adenocarcinoma of stages III–IV (FIGO 2015) who were treated at the University Clinic of Odesa National Medical University was conducted. Patients were divided into 2 groups: Group IA — patients with primary ovarian cancer who were treated with primary cytoreductive surgery (PDS) + adjuvant chemotherapy (ACT) — 43 patients; IB group — patients with primary ovarian cancer who were treated with neoadjuvant chemotherapy (NACT) + interval cytoreductive surgery (ICS) + adjuvant chemotherapy — 16 patients. Results: the absence of statistical difference in the median overall survival in groups IA (PDS + ACT) and IB (NACT + ICS + ACT) was shown to be explained by the complete volume of cytoreduction performed. There was a change in 3-year survival from 56.3 to 70.7% (χ2 = 0.951; p = 0.329) and an increase in 5-year survival from 12.5 to 60.9% (φ = 0.0012; p < 0.05). In group IB, the percentage of postoperative complications in patients and the average length of hospital stay after cytoreductive surgery were lower than in group IA, but the difference was statistically insignificant. When comparing the frequency of side effects of paclitaxel/carboplatin chemotherapy treatment in groups IA and IB, the values of χ2 = 36.441; p = 0.0195 were obtained. Thus, it was proved that in the IB group, the toxic effects of chemotherapy of 3–4 degrees of severity were significantly more common. Conclusions: there was no statistical difference when comparing the median overall survival and progression-free survival in the study groups. It has also been shown that primary cytoreductive surgery with macroscopically visible residual masses, especially in suboptimal and suboptimal volume (CC 2-3), leads to a significant decrease in survival rates in patients with ovarian cancer.