title: Clinical outcome of neoadjuvant chemotherapy for advanced ovarian cancer.
abstract: To evaluate clinical outcome in patients selected to receive neoadjuvant chemotherapy (NACT) compared to primary debulking surgery (PDS).
  
  
  
  Retrospective study including all consecutive patients diagnosed and treated for advanced (stages III-IV) ovarian cancers between the years 2003-2015.
  
  
  
  263 women were included in the study, of these, 127 patients were selected to receive NACT and 136 were treated with PDS followed by adjuvant chemotherapy. PDS was associated with longer OS in stage IIIc disease (median OS: 60.2 vs. 48.8months; p-value 0.039) compared with NACT. Patients achieved higher rates of complete cytoreduction in the NACT group compared to the PDS group (65.9% vs. 40.2%; p=0.001). Patients attaining complete cytoreduction after PDS had the best survival, (median OS 106months) followed by those with complete cytoreduction after NACT (median OS 71months), followed by those with residual disease after PDS (median OS 55months). Patients with residual disease following interval debulking after NACT had the worst outcome (median OS 36months). Platinum sensitivity following first line and second line chemotherapy was similar whether patients received neoadjuvant chemotherapy or not.
  
  
  
  PDS was associated with improved outcome. NACT appears to improve survival outcome in patients that would have had residual disease after PDS, and attain complete cytoreduction at the time of interval cytoreduction. This treatment option can be used in selected patients that are not candidates for complete cytoreduction at PDS.
authors.affiliation: Division of Gynecologic Oncology, Segal Cancer Center, Jewish General Hospital, McGill University, Montreal, QC, H3T 1E2, Canada.
authors.forename: Roy
authors.initials: R
authors.lastname: Kessous
authors.affiliation: Division of Gynecologic Oncology, Segal Cancer Center, Jewish General Hospital, McGill University, Montreal, QC, H3T 1E2, Canada.
authors.forename: Ido
authors.initials: I
authors.lastname: Laskov
authors.affiliation: Division of Gynecologic Oncology, Segal Cancer Center, Jewish General Hospital, McGill University, Montreal, QC, H3T 1E2, Canada.
authors.forename: Jeremie
authors.initials: J
authors.lastname: Abitbol
authors.affiliation: Division of Gynecologic Oncology, Segal Cancer Center, Jewish General Hospital, McGill University, Montreal, QC, H3T 1E2, Canada.
authors.forename: Joanna
authors.initials: J
authors.lastname: Bitharas
authors.affiliation: Division of Gynecologic Oncology, Segal Cancer Center, Jewish General Hospital, McGill University, Montreal, QC, H3T 1E2, Canada.
authors.forename: Amber
authors.initials: A
authors.lastname: Yasmeen
authors.affiliation: Division of Gynecologic Oncology, Segal Cancer Center, Jewish General Hospital, McGill University, Montreal, QC, H3T 1E2, Canada.
authors.forename: Shannon
authors.initials: S
authors.lastname: Salvador
authors.affiliation: Division of Gynecologic Oncology, Segal Cancer Center, Jewish General Hospital, McGill University, Montreal, QC, H3T 1E2, Canada.
authors.forename: Susie
authors.initials: S
authors.lastname: Lau
authors.affiliation: Division of Gynecologic Oncology, Segal Cancer Center, Jewish General Hospital, McGill University, Montreal, QC, H3T 1E2, Canada. Electronic address: walter.gotlieb@mcgill.ca.
authors.forename: Walter H
authors.initials: WH
authors.lastname: Gotlieb
mesh_terms: D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Neoadjuvant chemotherapy; Ovarian cancer; Platinum resistance; Primary debulking surgery