Predictive factors involved in determining response to neoadjuvant chemotherapy in high grade serous ovarian cancer and impact of response on 5 years disease free survival and overall survival

Abstract

Aim: To evaluate all the known factors that may play a role in predicting response to chemotherapy and to see impact of response on five years’ disease free survival (DFS) and overall survival (OS). Methods: Data of 156 patients was reviewed retrospectively from January 2012 to December 2012 at Shaukat Khanum Memorial Cancer Hospital and Research Centre Lahore, Pakistan. All received neoadjant chemotherapy (NAC)and had no distant metastasis. The response was measured in term of percentage ureduction from 1st radiological size on presentation to final size on histopathology (on resected specimen). Four groups were identified, complete responder (CR) (100% reduction),Responders (R) (>50% reduction),Partial responder (PR) (<50% reduction) and Non-responder (NR).. Results: Median age of patients was 45 years (25-64 years). 67% of patient underwent debulking surgery on ovarian protocol without pelvic node dissection. Mortality for whole group was 22%, and recurrence was shown in 34%(Majority 26% were distant). Out of 156 patients, 25% of patients were CR, 13% were NR, 23% were PR and 37% were R. Progesterone receptor negative and Grade III tumors showed more complete responses. The Rest of the factors, including, initial T and N stage and other factors showed no impact on chemo-response. Survival was significantly poor in NR group (45% OS, 40% DFS), while rest of three groups had comparable survival outcome, with CR group having best survival outcome (86% OS, 80% DFS). Conclusion: Most of factors studied did not show impact on achieving good chemo response, however good chemo response did show better survival.