Neoadjuvant chemotherapy versus upfront debulking surgery in advanced tubo-ovarian cancer
2018; Elsevier BV; Volume: 19; Issue: 12 Linguagem: Inglês
10.1016/s1470-2045(18)30625-9
ISSN1474-5488
AutoresAnna Fagotti, Giovanni Scambia,
Tópico(s)Endometrial and Cervical Cancer Treatments
ResumoIn The Lancet Oncology, Ignace Vergote and colleagues report a per-protocol pooled analysis of individual patient data from the randomised EORTC 55971 and CHORUS trials. 1 Vergote I Coens C Nankivell M et al. Neoadjuvant chemotherapy versus upfront debulking surgery in advanced tubo-ovarian cancers: pooled analysis of individual patient data from the EORTC 55971 and CHORUS trials. Lancet Oncol. 2018; (published online Nov 6.)http://dx.doi.org/10.1016/S1470-2045(18)30566-7 Summary Full Text Full Text PDF PubMed Scopus (133) Google Scholar In a comparison of neoadjuvant chemotherapy and upfront debulking surgery, they noted no difference in overall survival among 1220 women with International Federation of Gynecology and Obstetrics (FIGO) stage III–IV tubo-ovarian cancer. Median overall survival, which was the primary endpoint of the analysis, was 26·9 months (IQR 12·7–50·1) in patients randomly allocated to receive upfront debulking surgery, and 27·6 months (14·1–51·3) in women randomly assigned to neoadjuvant chemotherapy (hazard ratio [HR] 0·97, 95% CI 0·86–1·09; p=0·586). In subgroup analyses, a gain of 3 months in median overall survival was noted for neoadjuvant chemotherapy as compared with upfront debulking surgery in 230 patients with stage IV disease, whereas overall survival was better with upfront debulking surgery than with neoadjuvant chemotherapy in 266 women with stage IIIC disease and extrapelvic metastases smaller than 5 cm. Neoadjuvant chemotherapy versus debulking surgery in advanced tubo-ovarian cancers: pooled analysis of individual patient data from the EORTC 55971 and CHORUS trialsLong-term follow-up data substantiate previous results showing that neoadjuvant chemotherapy and upfront debulking surgery result in similar overall survival in advanced tubo-ovarian cancer, with better survival in women with stage IV disease with neoadjuvant chemotherapy. This pooled analysis, with long-term follow-up, shows that neoadjuvant chemotherapy is a valuable treatment option for patients with stage IIIC–IV tubo-ovarian cancer, particularly in patients with a high tumour burden at presentation or poor performance status. Full-Text PDF
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