Histological response is not a prognostic factor after neoadjuvant chemotherapy in advanced-stage ovarian cancer with no residual disease.
OBJECTIVE
The aim of this study was to evaluate the prognostic impact of the histological response at the time of interval debulking surgery (IDS) in patients treated with neoadjuvant chemotherapy (NACT) for unresectable advanced-stage ovarian cancer (ASOC).


METHODS
A retrospective study to select cases fulfilling 4 inclusion criteria: (1) patients with unresectable ASOC; (2) at least 3 courses of platinum and paclitaxel NACT; (3) patients who underwent IDS after NACT and who were free of macroscopic residual disease at the end of debulking surgery and (4) histologic analysis of specimens performed in the same institution. Patients were classified into 3 groups according to the histological response to NACT group 1: no histologic residual disease; group 2: persistent residual disease but with marked histological changes and group 3: persistence of at least 1 site with no changes in the tumour. Survival was compared.


RESULTS
Fifty-eight patients (49 stage IIIC and 9 stage IV) fulfilled inclusion criteria. Respectively 8, 14 and 36 patients were in groups 1, 2 and 3. The median duration of follow-up was 41 months. Three-year event-free survival in groups 1, 2 and 3 was respectively: 63%, 12% and 19% (p=.02).


CONCLUSIONS
These results suggest that the degree of the histological response has a limited impact on survival when complete debulking surgery is achieved at IDS. The degree of tumour cell viability after initial chemotherapy is not a reliable marker for modifying chemotherapy after debulking surgery in such patients.
Ferron
Jean-Guillaume
JG
Department of Surgery, Institut Gustave Roussy, 94805 Villejuif, France.
Uzan
Catherine
C
Rey
Annie
A
Gouy
Sebastien
S
Pautier
Patricia
P
Lhommé
Catherine
C
Duvillard
Pierre
P
Morice
Philippe
P
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D016190:Carboplatin / Q000627:therapeutic use; D002470:Cell Survival; D004358:Drug Therapy / Q000379:methods*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology*; D017239:Paclitaxel / Q000627:therapeutic use; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D016190:Carboplatin; D017239:Paclitaxel