Primary debulking surgery versus neo-adjuvant chemotherapy in stage III/IV ovarian cancer: Comparison of perioperative morbidity and survival data in Pakistani women.
OBJECTIVE
To compare the peri-operative morbidity and survival rates between ovarian cancer patients treated with two different approaches.


METHODS
The retrospective study was conducted at Aga Khan University Hospital, Karachi, and comprised data related to patients with advanced stage ovarian carcinoma treated between 1999 and 2008. Medical records were reviewed and relevant demographic, clinical, surgical, pathologic and follow-up information was acquired. Progression-free survival and overall survival rates were compared between patients who underwent primary debulking surgery and those who had received neo-adjuvant chemotherapy before surgery. SPSS 19 was used for statistical analysis.


RESULTS
Of the total 118 patients, 78(66%) had undergone primary debulking surgery and 40(34%) had received neo-adjuvant chemotherapy. The mean age and pre-operative carcinoma antigen-125 level were similar. The debulking group had 74(94.8%) patients with stage 3, and 4(5.1%) patients with stage 4 disease, while the other group had 32(80%) and 8(20%) with stage 3and 4 respectively. The frequency of optimal debulking was 42(56.8%) in the former group against 27(79.4%) in the latter (p=0.01). Duration of surgery, estimated blood loss >1500ml and stay at the intensive care unit were not statistically different (p>0.05). Rate of Urinary tract, bowel injury and bowel resections were also similar. There was no difference in the progression-free survival in both groups (p>0.05).


CONCLUSIONS
Neo-adjuvant chemotherapy followed by interval debulking produced comparable survival rates and peri-operative complications.
Kafkas University School of Medicine, Departments of Urology, Kars, Turkey.
Uzma
U
Chishti
Department of Obstetrics and Gynaecology, Aga Khan University Hospital, Karachi, Pakistan.
Aliya Begum
AB
Aziz
D018262:Adenocarcinoma, Clear Cell / Q000097:blood / Q000473:pathology / Q000628:therapy*; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018394:CA-125 Antigen / Q000097:blood; D016190:Carboplatin / Q000008:administration & dosage; D018269:Carcinoma, Endometrioid / Q000097:blood / Q000473:pathology / Q000628:therapy*; D065426:Cytoreduction Surgical Procedures / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D009367:Neoplasm Staging; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000097:blood / Q000473:pathology / Q000628:therapy*; D010051:Ovarian Neoplasms / Q000097:blood / Q000473:pathology / Q000628:therapy*; D010052:Ovariectomy; D017239:Paclitaxel / Q000008:administration & dosage; D010154:Pakistan; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome
D018394:CA-125 Antigen; D016190:Carboplatin; D017239:Paclitaxel
Ovarian epithelial cancer, Chemotherapy, Gynaecological surgical procedure, Survival analysis.