Clinical Outcome of Iranian Patients with Advanced Ovarian Cancer with Neoadjuvant Chemotherapy versus Primary Debulking Surgery

Objective: The aim of this study is to evaluate the results of neoadjuvant chemotherapy (NACT) and theimpact of interval debulking surgery (IDS) on clinical outcomes of patients with advanced-stage ovarian cancer.
Methods: We performed a retrospective analysis on 92 patients with advanced ovarian cancer admitted to Vali-Asr Gynecologic oncology departments during 1996–2002. Comparison was made with results of neoadjuvantchemotherapy of 24 patients with unresectable advanced epithelial ovarian cancer treated with platinum- basedNACT followed by IDS and clinical outcomes of 68 consecutive stage III and IV ovarian cancer patients treatedwith primary cytoreduction followed by platinum-based adjuvant chemotherapy.
Results: Primary cytoreductivesurgery caused longer survival compared to neoadjuvant chemotherapy. Patients who underwent optimal intervaldebulking surgery (IDS) had a better progression free survival (PFS) (p=0.002) and overall survival (p=0.03)than those who did not. There were not significant differences between the two groups in complications ofsurgery.
Conclusion: NACT followed by successful IDS can lead to high survival percentage in patients withchemoresponsive advanced ovarian cancer; although the result is more effective in those with optimal primarycytoreduction, we still got the same results with those with suboptimal primary cytoreduction.