Experience with neoadjuvant therapy and interval surgery in unresecable ovarian cancer

Abstract

Objective: To describe the experience with neoadjuvant therapy and interval surgery in unresectable ovarian cancer in patients who attended the Gynecology Oncology Service at the La Trinidad Teaching Medical Center and the La Floresta Medical Institute, between 2015 and 2023. Methods: Retrospective, descriptive, cross-sectional study included 16 patients who attended the general surgery service, the Gynecology-Oncology consultation, diagnosed with unresectable stage III-IV ovarian cancer, with epithelial histology. Response to neoadjuvant treatment and interval surgery was evaluated and overall and disease-free survival was established. Results: Pretreatment, the median Ca 125 was 435U/ml (272-1258 U/ml). Posttreatment was 50U/ml (34 and 98 U/ml) (p˂0.001); 25% of patients had normal levels, in all cases decreased. Tumor size was reduced from 5.0-7.0 cm to 3.5 cm (3-4.8 cm) (p˂0.001). In 100% of the patients, optimal surgery was achieved, without intra- or postoperative complications. The overall survival between 6 months and 1 years and between 1 and 3 years was 62.5 %. Currently 10 patients survive. Disease-free survival ≤ was 87.5 %; between 6 months and one year 62.5%; and between 1 and 3 years it was 56.3 %. Seven patients 43.8 % had relapses, 6 37.5 % in two simultaneous locations and 1 6.25 % in three. All had carcinomatosis, associated with pelvic mass, pelvic and/or para-aortic adenomegaly, visceral lesion or other locations. Conclusion: The response to the treatment provided by ARSUVE was satisfactory, allowing complete resectability in all cases, without complications. The 3-year overall survival is high.