Interval or Late Debulking Surgery in Advanced Ovarian Cancer: Progression Free and Overall Survival Advantages

Purpose: Interval (IDS) or late debulking surgery (LDS) following neoadjuvant chemotherapy (NAC) may have a role in treating advanced epithelial ovarian cancer (AEOC) where primary debulking surgery is not possible. We aimed to study the outcome of such patients who were treated in our centre during the last 3 years. Methods: This was retrospective study of AEOC patients who had NAC with or without IDS/LDS in the City General Hospital, Stoke-On-Trent between May 2011 and July 2014. Results: Forty six patients with AEOC were treated under our oncology team during that period. Thirty one patients (67.4%) were in stages III and 15 were in stage IV (32.6%). All patients were recommended NAC; 30 patients (65.2%) had paclitaxel and carboplatin regimen and 16 (34.8%) single agent carboplatin. Response to chemotherapy was assessed after 2 cycles. Twenty seven patients (58.7%) had partial response, 16 (34.8%) stable disease and 3 (6.5%) progressive disease. Seventeen patients (37%) proceeded to IDS after cycle 3 and 4 patients (8.7%) to LDS after cycle 6. After a median follow-up period of 12 months, 39 patients (84.8%) had relapsing/progressive disease. The median progression free survival duration (PFS) for all patients was 9 months and 2 years PFS probability was 4.5%. The median PFS was 10 months for patients who had either IDS or LDS compared to 8 months for no debulking. The median overall survival (OS) duration was not reached yet but the 2 years OS probability was 76% for all patients; 94% for patients who had IDS and 58% for no debulking. One year OS probability for patients who had late debulking was 100%. Conclusion: In our study, we documented PFS and OS advantages for patients who IDS or LDS and therefore should be considered whenever possible as part of the primary treatment of AEOC patients.