May T, et al. - In this multicenter study, patterns of clinical practice in managing women with advanced high-grade serous ovarian carcinoma (HGSC) were assessed. Patients who underwent PCS showed longer survival than patients who underwent neoadjuvant chemotherapy (NACT). Highest survival was noted for those who had complete cytoreduction to 0-mm residual disease within each group. A gynecologic oncologist is suggested to assess all patients with advanced HGSC for the feasibility of surgical resection. In case 0 mm residual is not feasible, researchers recommend attempting PCS to a residual of 1 to 9 mm given the survival advantage in this group over patients who were treated with NACT.

Methods

• This retrospective cohort analysis included 852 patients with advanced HGSC.
• Primary cytoreductive surgery (PCS) or neoadjuvant chemotherapy(NACT) was received by the patients.
• Researchers applied Wilcoxon rank-sum test and X² test.
• They performed univariate- and multivariate-analyses, and measured survival outcomes using Kaplan–Meier curves.

Results

• PCS was performed on a total of 449 (53%) of 852 patients, and NACT was provided to 403(47%) of 852 patients.
• Researchers assessed a median 5-year overall survival (OS) of 3.89 in PCS and 2.48 in NACT.
• In this study, patients with 0 mm residual had OS of 4.66, compared with 1- to 9-mm residual (OS=2.80) and 10-mm residual or longer (OS=2.50).
• In PCS, the survival advantage harbored by the extent of surgical cytoreduction was more pronounced compared with NACT (P < 0.001).
• Data demonstrated that patients who had PCS with 1- to 9-mm residual had similar OS to NACT patients with 0-mm residual (P=0.17) and superior OS to NACT with 1- to 9-mm residual (P < 0.001).