Three Therapeutic Modalities for Advanced Ovarian Cancer: Real-World Data from a Certified Oncological Center

Area of Science:

• Gynecologic Oncology
• Surgical Oncology
• Medical Oncology

Background:

• Advanced ovarian cancer (FIGO Stage IIIC-IV) treatment involves either upfront radical surgery (URS) or neoadjuvant chemotherapy followed by interval debulking surgery (NACT/IDS).
• Maintenance therapies are increasingly important and can be used in patients not undergoing surgery.

Purpose of the Study:

• To compare the outcomes of URS versus NACT/IDS in advanced epithelial ovarian cancer patients.
• To evaluate the role of maintenance therapies in patients unsuitable for surgery.

Main Methods:

• Retrospective analysis of advanced epithelial ovarian cancer patients (FIGO Stage IIIC-IV) over 7 years.
• Comparison of surgical outcomes, survival rates (OS and PFS), and patient characteristics between URS and NACT/IDS groups.

Main Results:

• Patients in the NACT/IDS group had higher ECOG scores and CA125 levels at diagnosis.
• Complete macroscopic tumor resection was more frequent in the URS group, leading to significantly higher OS and PFS.
• No significant differences in surgery length, ICU stay, or transfusion needs were observed. NACT/IDS patients had fewer bulky lymph nodes requiring resection or intestinal resections.

Conclusions:

• Radical surgery aiming for no residual tumor should be prioritized when feasible, considering patient and disease factors.
• NACT/IDS is a viable alternative for patients not suitable for upfront surgery.
• Maintenance therapies may offer significant benefits, including long remission and good quality of life, for patients ineligible for surgery.