Longterm outcomes of surgery for advanced ovarian cancer during interval cytoreduction

Aim. To compare long-term oncological outcomes of extended, combined, and standard surgical interventions. Materials and methods. The study included women with histologically verified T3-4N0-1M0-1ovarian cancer. Patients in group A underwent extended and combined surgical interventions, while patients in group B were subjected to standard surgery. In the preoperative period, all patients received 6 courses of PCT, a combination of platinum and taxanes. We compared the rates of achieving optimal and conditionally radical operations after extended and combined operations and standard surgical procedures at the stage of interval cytoreduction. The structure, rates and causes of intra- and postoperative complications were estimated. The endpoints analyzed were overall and recurrence-free survival. Results. From 2010 to 2018, we selected archived medical records of 150patients with advanced ovarian cancer (stages IIIC-IV). Long-term follow-up data were available for 143 (95.3%) patients. In groups A and B, complete cytoreduction was achieved in 56.7% and 40.8% of patients, respectively. In group A, 10 (33.3%) patients had intraoperative complications; 6 (19.9%) and 2 (6.7%) patients had grade I-II and grade III-IVpostoperative complications, respectively (p = 0.82). In group B, intraoperative complications were seen in 16 (13.3%) patients. Postoperative grade I-II and grade III-IVcomplications were observed in 22 (18.3%) and 7 (5.8%) patients, respectively. The median follow-up in the study and control group was 39 and 29 months, respectively. The median of RFS in the study group was not achieved; in the control group, it was 10.48 months (CI95% 8.233-12.66). In the study group, three-year recurrence-free survival was 59%. In the control group, three-year recurrence-free survival was 21%. Median OS in the study group was not achieved; in the control group, it was 37.3 months. (CI 95% 30.51-44.07). In the study group, three-year overall survival was 79 months. In the control group, three-year overall survival was 43%. Conclusion. Combined and extended surgical interventions for advanced ovarian cancer at the stage of interval cytoreduction are feasible and associated with better oncological outcomes of complete cytoreduction.

ovarian cancer, surgical treatment, interval cytoreduction, overall and recurrence-free survival