Investigating the effect of optimal cytoreduction in the context of platinum sensitivity in high‐grade serous ovarian cancer

Introduction The survival benefits of surgical cytoreduction in ovarian cancer are well‐established. However, the surgical outcome has never been assessed while controlling for the efficacy of chemotherapy. This leaves the possibility that cytoreduction may not be beneficial for patients whose cance...

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Published in:Acta obstetricia et gynecologica Scandinavica 2022-10, Vol.101 (10), p.1085-1092
Main Authors: Cardillo, Nicholas, Devor, Eric, Calma, Christian, Pedra Nobre, Silvana, Gabrilovich, Sofia, Bender, David P., Goodheart, Michael, Gonzalez‐Bosquet, Jesus
Format: Article
Language:English
Subjects:
Cancer surgery
Carcinoma, Ovarian Epithelial - surgery
Case-Control Studies
Chemotherapy
Chemotherapy, Adjuvant
Clinical outcomes
cytoreduction
Cytoreduction Surgical Procedures
Female
Humans
Multivariate analysis
Neoplasm Staging
Oncology
Original
Ovarian cancer
Ovarian Neoplasms - drug therapy
Ovarian Neoplasms - pathology
Ovarian Neoplasms - surgery
overall survival
platinum‐resistant
platinum‐sensitive
Retrospective Studies
Surgical outcomes
Survivor
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Summary:Introduction The survival benefits of surgical cytoreduction in ovarian cancer are well‐established. However, the surgical outcome has never been assessed while controlling for the efficacy of chemotherapy. This leaves the possibility that cytoreduction may not be beneficial for patients whose cancer does not respond well to adjuvant treatment. We sought to answer whether surgical cytoreduction independently improves overall survival when controlling for chemotherapy outcome. Material and Methods We performed a retrospective case–control study using our institution's ovarian cancer database to evaluate the effect of optimal cytoreduction on advanced stage, high‐grade serous ovarian cancer. Patients' characteristics were compared using both univariate and multivariate regression modeling to assess for independent predictors of overall survival. Results A total of 470 patients were assessed for inclusion; 234 responders to chemotherapy and 98 nonresponders. Significant survival characteristics were identified and included in the multivariate analysis. Independent predictors of survival in the multivariate analysis were age, responder status, optimal cytoreduction, neoadjuvant chemotherapy, and number of chemotherapy cycles. Kaplan–Meier survival curves showed improved survival for both patients who responded to chemotherapy and for those undergoing optimal cytoreduction (p 
ISSN:0001-6349
1600-0412
DOI:10.1111/aogs.14415