Neoadjuvant Chemotherapy

Title. NEOADJUVANT CHEMOTHERAPY VERSUS PRIMARY SURGERY IN ADVANCED OVARIAN CANCER. MORBIDITY AND PROGRESSION FREE STUDY
H.Priyanto,A.Andrijono Oncology Division - Department of Obstetrics and Gynecology.Faculty of Medicine University of Indonesia -Dr. Cipto Mangunkusumo Hospital. 6 Salemba Raya Street Jakarta 10430 –Indonesia
Objective. The aim of the study was to compare the morbidity and progression free of disease women with advanced ovarian cancer treated with neoadjuvant chemotherapy (NAC) followed by surgery with those treated conventionally with cytoreductive surgery followed by cytotoxic chemotherapy.
Materials and methods. : Eighty –four consecutive patients with advanced-stage ovarian cancer based on extend of disease on clinical impression and imaging between 2000-2004 were reviewed retrospectively. 64 patients treated conventionally (CT) with primary surgery followed by platinum-based adjuvant chemotherapy, 20 patients treated with neoadjuvant chemotherapy (NAC),and eighth patiens subsequently underwent interval debulking and adjuvant chemotherapy
Results : The response rate to NAC assessed at three cycles was 40 %. Performance status ( Hb, Albumin, Ascites, Pleural Efusion, Ca 125 and Stage ) NAC group was worse than CT group. Progression free of disease 12 and 24 mounths on NAC was 30% and 5 %,CT group was 10% and 7,5 %. Parameters of surgical aggressiveness ( massive bleeding, organ injury and ICU stay ) were significantly lower in NAC group than the conventional group. Complication rate of surgical injury on CT group was 17 % and zero on NAC group.
Conclusion : Neoadjuvat chemotherapy followed by interval debulking in advaced ovarian cancer does’t effect on progression free of disease but significantly reduce morbidity and permit a less aggressive surgery to be performed.

Presented on - FIGO 2006 World Congress - Kuala Lumpur, Malaysia
- ESGO 2007 15th International Meeting-Berlin,Germany