[HTML][HTML] The role of neoadjuvant chemotherapy followed by interval debulking surgery in advanced ovarian cancer: a systematic review and meta-analysis of …

M Qin, Y Jin, L Ma, YY Zhang, LY Pan - Oncotarget, 2018 - ncbi.nlm.nih.gov
M Qin, Y Jin, L Ma, YY Zhang, LY Pan
Oncotarget, 2018ncbi.nlm.nih.gov
Objective We aimed to performed a meta-analysis and systematic review on the role of
neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS) in advanced
ovarian cancer (AOC) patients. Materials and Methods We searched PubMed, EMBASE,
and the Cochrane Library for relevant articles. All statistical analyses were performed in
Review Manager 5.3. 5. Results In two randomized controlled trials (RCTs), there was no
significant difference in overall survival (OS)(HR= 0.93, 95% CI: 0.81–1.06) or progression …
Abstract
Objective
We aimed to performed a meta-analysis and systematic review on the role of neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS) in advanced ovarian cancer (AOC) patients.
Materials and Methods
We searched PubMed, EMBASE, and the Cochrane Library for relevant articles. All statistical analyses were performed in Review Manager 5.3. 5.
Results
In two randomized controlled trials (RCTs), there was no significant difference in overall survival (OS)(HR= 0.93, 95% CI: 0.81–1.06) or progression-free survival (PFS)(HR= 0.97, 95% CI: 0.86–1.09). Few adverse events (HR= 0.37, 95% CI: 0.19–0.72) and a high optimal debulking surgery rate (HR= 1.69, 95% CI: 1.50–1.91) were observed with NACT. In 22 observational studies, primary debulking surgery (PDS) yielded better OS (HR= 1.38, 95% CI: 1.19–1.60) but not progression-free survival (PFS)(HR= 1.03, 95% CI: 0.86–1.23). An increased optimal cytoreduction rate (HR= 1.17, 95% CI: 1.12–1.22) was observed with NACT. Irrespective of the degree of residual disease, OS was longer in the PDS group than that in the NACT group. Patients with FIGO stage III (HR= 1.43, 95% CI: 1.05–1.95) and IV (HR= 1.14, 95% CI: 1.06–1.23) disease had better survival with PDS.
Conclusions
Treatment with NACT-IDS improves perioperative outcomes and optimal cytoreduction rates, but it may not improve OS. NACT-IDS is not inferior to PDS-CT in terms of survival outcomes in selected AOC patients. Future studies should focus on candidate selection for NACT.
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