Survival after primary surgery compared with neoadjuvant chemotherapy in early-stage ovarian cancer

Abstract

Background/Aim: Our study evaluated the survival of women with early-stage ovarian cancer treated with neoadjuvant chemotherapy (NAC) vs. primary debulking surgery (PDS). Patients and Methods: We used the 2004-2015 National Cancer Database to identify women with early ovarian cancer treated with multiagent chemotherapy or surgery. Logistic regression was used to identify predictors of NAC. Overall survival estimates were compared using Kaplan–Meier analysis and Cox proportional hazards regression models were used to examine variables. Results: In total, 14,627 women were included. The majority (96%) underwent PDS while (4%) underwent NAC. Median survival time was 40 months (95%CI=37.190-47.280, p<0.0001) in the NAC group and 91 months (95%CI=84.4-110.290, p<0.0001) in the PDS group. Five-year overall survival was 36% for the NAC cohort and 65% for the PDS cohort. Conclusion: Women treated with neoadjuvant chemotherapy (NAC) had worse overall and 5-year survival. This finding agrees with the accepted convention of reserving NAC for women with advanced, unresectable disease.