title: Neoadjuvant Chemotherapy in Advanced Ovarian Cancer: A Single-Institution Experience and a Review of the Literature.
abstract: OBJECTIVE
  The aim of this study was to evaluate the role of neoadjuvant chemotherapy (NACT) in advanced ovarian carcinoma patients unable to undergo a complete resection during primary debulking surgery.
  
  
  METHODS
  From February 2005 to October 2015, all consecutive cases of advanced-stage epithelial ovarian carcinoma at the University of Bari were retrospectively recorded. Of them, patients treated with NACT were collected. Kaplan-Meier and Cox proportional hazards analyses were used to determine the predictors of survival.
  
  
  RESULTS
  Seventy-eight women with advanced-stage epithelial ovarian carcinoma were treated with NACT. On univariate analysis, age (p = 0.003), CA-125 serum level (0.001), response to NACT (p < 0.0001), stage of disease (p = 0.011) and optimal debulking surgery (p < 0.0001) were found to be important prognostic factors related to survival. However, on multivariate analysis, age, response to NACT, CA-125 serum level and optimal debulking surgery remained as independent poor prognostic factors for survival. The median overall and disease-free survival were 31 and 12 months, respectively.
  
  
  CONCLUSIONS
  NACT does not compromise survival in patients with stage IIIC and IV ovarian cancer compared to patients treated with primary surgery. Prospective randomized trials comparing NACT to conventional treatment are needed to determine the quality of life and cost/benefit outcomes for women presenting advanced epithelial ovarian cancer.
authors.affiliation: Dipartimento di Scienze Biomediche e Oncologia Umana, University of Bari, Bari, Italy.
authors.forename: Vera
authors.initials: V
authors.lastname: Loizzi
authors.forename: Luca
authors.initials: L
authors.lastname: Leone
authors.forename: Anna
authors.initials: A
authors.lastname: Camporeale
authors.forename: Leonardo
authors.initials: L
authors.lastname: Resta
authors.forename: Luigi
authors.initials: L
authors.lastname: Selvaggi
authors.forename: Ettore
authors.initials: E
authors.lastname: Cicinelli
authors.forename: Gennaro
authors.initials: G
authors.lastname: Cormio
mesh_terms: D000367:Age Factors; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018394:CA-125 Antigen / Q000097:blood; D017024:Chemotherapy, Adjuvant; D065426:Cytoreduction Surgical Procedures; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy* / Q000556:secondary* / Q000601:surgery; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D010052:Ovariectomy; D010388:Pelvis; D066066:Response Evaluation Criteria in Solid Tumors; D012189:Retrospective Studies; D058994:Salpingectomy; D015996:Survival Rate
chemical_list: D018394:CA-125 Antigen; D009944:Organoplatinum Compounds