title: Does the Number of Neoadjuvant Chemotherapy Cycles before Interval Debulking Surgery Influence Survival in Advanced Ovarian Cancer?
abstract: OBJECTIVE
  To evaluate the overall survival (OS) of patients with initially inoperable advanced ovarian cancer, tubal carcinoma, or primary peritoneal carcinoma of stages III or IV undergoing neoadjuvant chemotherapy (NAC) followed by cytoreductive surgery, according to the number of cycles performed.
  
  
  METHODS
  This retrospective study was conducted in three main oncology centres in the east of France, reviewing the charts of all patients who underwent NAC between January 1, 1998 and October 31, 2012. We performed an OS analysis using multivariate Cox regression models adjusted for potential confounders. We also analysed progression-free survival (PFS) as well as chemotherapy- and surgery-related morbidity.
  
  
  RESULTS
  Of the 204 patients included, 75 (36.8%) underwent ≤4 NAC cycles and 129 (63.2%) ≥5 NAC cycles. Characteristic data were similar in the two groups. Five-year OS was 35.0 and 25.8%, respectively. This difference was non-significant [HR = 1.06 (0.70-1.59), p = 0.79]. We also found no differences in PFS or morbidity between the two groups.
  
  
  CONCLUSIONS
  The number of NAC cycles does not seem to play a role in the OS of patients with advanced ovarian cancer. Further evidence and prospective data are needed to assess the value of a high/low number of NAC cycles among these patients.
authors: Département de Gynécologie Obstétrique, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors: Cherif
authors: C
authors: Akladios
authors: Jean-Jacques
authors: JJ
authors: Baldauf
authors: Frederic
authors: F
authors: Marchal
authors: Michel
authors: M
authors: Hummel
authors: Laure-Emilie
authors: LE
authors: Rebstock
authors: Jean-Emmanuel
authors: JE
authors: Kurtz
authors: Thierry
authors: T
authors: Petit
authors: Karolina
authors: K
authors: Afors
authors: Carole
authors: C
authors: Mathelin
authors: Lise
authors: L
authors: Lecointre
authors: Stéphanie
authors: S
authors: Schrot-Sanyan
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D016190:Carboplatin / Q000008:administration & dosage; D002277:Carcinoma / Q000556:secondary* / Q000628:therapy*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects / Q000379:methods; D065426:Cytoreduction Surgical Procedures / Q000009:adverse effects; D018572:Disease-Free Survival; D000077143:Docetaxel; D005185:Fallopian Tube Neoplasms / Q000473:pathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000628:therapy*; D010534:Peritoneal Neoplasms / Q000473:pathology* / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate; D043823:Taxoids / Q000008:administration & dosage
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D016190:Carboplatin