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