SGO 2020 — Advanced ovarian cancer: concomitant increase in neoadjuvant chemotherapy use and survival

  • SGO 2020
  • 29 Mar 2020

  • curated by Pavankumar Kamat
  • Univadis Clinical Summaries
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Takeaway

  • As uptake of neoadjuvant chemotherapy (NAC) has consistently increased for the treatment of advanced ovarian cancer in the United States, median survival has also increased.

Why this matters

  • Previous evidence suggested that NAC does not negatively affect outcomes in advanced ovarian cancer and instead may reduce postoperative morbidity and mortality.

Study design

  • From the National Cancer Database, researchers identified 72,171 women with stage IIIC/IV epithelial ovarian cancer treated using chemotherapy, surgery, or both from 2004 to 2016.
  • Funding: None disclosed.

Key results

  • From 2004 to 2006, 17.6% of women received NAC followed by interval debulking surgery, and NAC uptake did not change during this period (P=.54).
  • Beginning in 2006, the frequency of primary chemotherapy started to rise (P<.001 increasing by per year between and>
  • After 2011, there was a significant acceleration in the uptake of primary chemotherapy (P=.01), increasing by 10.3% per year between 2010 and 2016. 
  • By 2016, 45.1% of patients received up-front chemotherapy followed by interval debulking surgery. 
  • Median survival increased from 31.1 months in 2004 to 37.8 months in 2013.

Limitations

  • Causality between wider uptake of NAC and the continuing increase in survival could not be established.