Meyer LA, et al. - Researchers assessed the usage patterns and outcomes of neoadjuvant chemotherapy (NACT) in a population-based cohort of elderly women with ovarian cancer (OC), in light of the premise that NACT may reduce perioperative morbidity in women undergoing primary treatment for ovarian cancer. Based on the findings, they recommended careful consideration be given to older patients before undergoing PCS. Patients with stage IV disease had similar survival outcomes, although NACT vs PCS was found to be related to decreased perioperative morbidity. They also noted improved overall survival, but higher rates of perioperative morbidity and acute care, related to PCS in women with stage III disease.

Methods

• Researchers used the SEER-Medicare database to select a cohort of patients ≥ 66 years old diagnosed between 2000 and 2013 with stage III-IV epithelial OC who had surgery and platinum/taxane chemotherapy for primary treatment.
• They assessed differences in outcomes using propensity-score matching methods and used Kaplan–Meier analysis to compare overall survival (OS) in the matched cohort.

Results

• Data showed 22.5% of older women received NACT from 2000 to 2013.
• Over time increase in the use of NACT was reported, from 16% in 2000 to 35.4% in 2013 (p < .0001).
• Higher rate of ostomy creation was reported in women who received PCS vs NACT (23.3% vs 10.8%, p < .0001).
• Higher infectious and other surgical complications, regardless of stage, were observed among those who had PCS.
• Longer median OS of women with stage III ovarian cancer who underwent PCS was noted, relative to NACT (38.8 vs 28 months, p ≤ .0001).
• Findings revealed no survival differences between NACT and PCS in women with stage IV disease (29.4 vs 29.8 months, p=.61) or for women aged > 80.