CLO22-060: > 3 Courses of Neo-Adjuvant Chemotherapy (NACT) May Affect Outcomes of Advanced Ovarian Serous Adenocarcinoma Patients

Authors: Yunyun Liu PhD1, KKL Chan PhD2, and Hui Zhou PhD1
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  • 1 Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
  • | 2 Queen Mary Hospital, University of Hong Kong, Hong Kong, China

Purpose: Neoadjuvant chemotherapy (NACT) can reduce tumor burden, lower difficulty of surgery in advanced ovarian cancer. However, the option of NACT cycle is still highly controversial. This paper intends to explore whether the number of NACT would impact prognosis of patients with advanced epithelial ovarian cancer. Method: 140 advanced ovarian serous adenocarcinoma patients (FIGO stage III-IV) from Gynecologic Oncology Departments of Sun Yat-sen Memorial Hospital and the Queen Mary Hospital were enrolled. All patients received NACT followed by interval debulking surgery (IDS) and post operation chemotherapy. Patients were divided into L group (NACT≤3) and M group (NACT>3). Stage, grade, age, cycles of post operation chemotherapy, debulking state, vital state were collected and analyzed. Multivariate cox regression and Kaplan-Meier method were employed to find risk factors of prognosis. Result: 1. baselines in the 2 groups of patients were similar. The optimal debulking rates were 78.18% and 78.95% in L group and M group. 2. The 3.5-year-OS are 75.1%±4.8% and 50.7%±6.0% in L group and M group, respectively. The median OS of M group was 3.64 years(95% CI: 2.55-4.74), while L group patients didn't reach the median OS. The difference of OS between 2 groups was statistically significant (P =0.034). Multivariate cox regression indicated more cycles of NACT (P =0.035) and platinum resistant (P <0.001) were the independent unfavorable risk factors of survival. 3. Subgroup analyses demonstrated that more cycles of NACT was the independent unfavorable risk factors of survival in platinum sensitive patients (P =0.038). While cycles of NACT didn't affect prognosis of platinum-resistant patients (P =0.771). 4. In M group, patients with R0 debulking didn't reach median OS, while the median OS of R2 patients was 2.87 years (P =0.086). In L group, median OS were 4.06, 2.81 and 1.99 years in patients with R0, R1 and R2 IDS, respectively (P =0.065). Conclusion: NACT>3 cycles didn't improve optimal debulking rate, and were associated with poorer survival in advanced stage ovarian serous adenocarcinoma patients, especially for platinum sensitive patients. While the cycles of NACT did not associate with platinum resistance and relapse, indicating that the poorer outcome of patients with NACT>3 may not be caused by chemo-induced resistance. The reason of worse outcomes after more cycles of NACT is still needed to be explored.

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CLO22-060 Figure 1

Citation: Journal of the National Comprehensive Cancer Network 20, 3.5; 10.6004/jnccn.2021.7208

CLO22-060 Table 1 clinicopathological parameters of patients.

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Abbreviations:

post-chemo: the course of post-surgery chemotherapy; debulking: the status of interval debulking surgery.

Corresponding Author: Hui Zhou, PhD
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