The published studies suggest that for selected women with stage IIIC or IV epithelial ovarian cancer , neoadjuvant chemotherapy and interval cytoreduction are non-inferior to primary cytoreduction and adjuvant chemotherapy with respect to overall and progression-free survival and are associated with less perioperative morbidity and mortality .
PURPOSE To provide guidance to clinicians regarding the use of neoadjuvant chemotherapy and interval cytoreduction among women with stage IIIC or IV epithelial ovarian cancer .
Prognostic factors for stage III epithelial ovarian cancer: a Gynecologic Oncology Group Study.
PURPOSE Conflicting results on prognostic factors for advanced epithelial ovarian cancer ( EOC ) have been reported because of small sample size and heterogeneity of study population . The purpose of this study was to identify factors predictive of poor prognosis in a similarly treated population of women with advanced EOC . PATIENTS AND METHODS A retrospective review of demographic , pathologic , treatment , and outcome data from 1,895 patients with International Federation of Gynecology and Obstetrics stage III EOC who had undergone primary surgery followed by six cycles of intravenous platinum/paclitaxel  was conducted . A proportional hazards model was used to assess the association of prognostic factors with progression-free survival ( PFS ) and overall survival ( OS ) . RESULTS Increasing age was associated with increased risks for disease progression ( HR = 1.06 ; 95 % CI , 1.02 to 1.11 for an increase every 10 years ) and death ( HR = 1.12 ; 95 % CI , 1.06 to 1.18 ) . Mucinous or clear-cell histology was associated with a worse PFS and OS compared with serous carcinomas . Patients with performance status ( PS ) 1 or 2 were at an increased risk for recurrence compared with PS 0 ( HR = 1.12 ; 95 % CI , 1.01 to 1.24 ) . Compared with patients with microscopic residual disease , patients with 0.1 to 1.0 cm and > 1.0 cm residual disease had an increased risk of recurrence ( HR = 1.96 ; 95 % CI , 1.70 to 2.26 ; and HR = 2.36 ; 95 % CI , 2.04 to 2.73 , respectively ) and death ( HR = 2.11 ; 95 % CI , 1.78 to 2.49 ; P < .001 ; and HR = 2.47 ; 95 % CI , 2.09 to 2.92 , respectively ) . CONCLUSION Age , PS , tumor histology , and residual tumor volume were independent predictors of prognosis in patients with stage III EOC . These data can be used to identify patients with poor prognosis and to design future tailored r and omized clinical trials
The published studies suggest that for selected women with stage IIIC or IV epithelial ovarian cancer , neoadjuvant chemotherapy and interval cytoreduction are non-inferior to primary cytoreduction and adjuvant chemotherapy with respect to overall and progression-free survival and are associated with less perioperative morbidity and mortality .
PURPOSE To provide guidance to clinicians regarding the use of neoadjuvant chemotherapy and interval cytoreduction among women with stage IIIC or IV epithelial ovarian cancer .