Primary cytoreductive surgery followed by chemotherapy compared to neoadjuvant chemotherapy followed by cytoreduction as a treatment for stage III and IV ovarian cancer (literature review)

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  • Authors: Sibirskaya E.V.1,2,3, Nikiforova P.O.4, Rabadanova N.R.5
  • Affiliations:
    1. Department of Obstetrics, Gynecology and Reproductive Medicine, Russian University of Medicine, Ministry of Health of Russia
    2. Russian Children Clinical Hospital – branch of the Pirogov Russian National Research Medical University, Ministry of Health of Russia
    3. Department of Obstetrics and Gynecology named after G.М. Savelyeva, Pirogov Russian National Research Medical University, Ministry of Health of Russia
    4. Pirogov National Medical and Surgical Center, Ministry of Health of Russia
    5. I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
  • Issue: Vol 20, No 1 (2024)
  • Pages: 124-130
  • Section: GYNECOLOGY. REVIEWS
  • Published: 18.05.2024
  • URL: https://ojrs.abvpress.ru/ojrs/article/view/1214
  • DOI: https://doi.org/10.17650/1994-4098-2024-20-1-124-130
  • ID: 1214

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Abstract

Standard treatment for advanced ovarian cancer (OC) consists of a combination of chemotherapy and cytoreductive surgery, but practice varies depending on the order of these 2 procedures: neoadjuvant chemotherapy followed by interval debulking surgery or primary cytoreduction followed by adjuvant chemotherapy. The aim of the work is to evaluate methods of treatment of OC of stages III, IV according to FIGO.
The literature review includes publications in English from the PubMed, CochraneLibrary and Google Scholar databases on the use of neoadjuvant therapy and primary cytoreduction in late stages of OC (FIGO III–IV). 6 randomized controlled trials, 8 meta-analyses, 8 systematic reviews, 1 case report were identified. Data from publications were distributed according to the criteria for assessing the effectiveness of the treatment: overall and relapse-free survival, perioperative complications, quality of life of patients and the grade of cytoreduction.
Neoadjuvant chemotherapy + interval debulking surgery is not inferior to primary debulking surgery + adjuvant chemotherapy in terms of survival outcomes in selected patients, but treatment with neoadjuvant chemotherapy + interval debulking surgery improves perioperative outcomes and optimal cytoreduction rates. It is needed to focus on finding optimal criteria for selecting patients in both groups in future studies of this issue. It is necessary to take into account X-ray, histological studies, the molecular subtype of the tumor, the patient’s condition, the qualifications of the surgical team, the drugs included in chemotherapy.

About the authors

E. V. Sibirskaya

Department of Obstetrics, Gynecology and Reproductive Medicine, Russian University of Medicine, Ministry of Health of Russia;
Russian Children Clinical Hospital – branch of the Pirogov Russian National Research Medical University, Ministry of Health of Russia;
Department of Obstetrics and Gynecology named after G.М. Savelyeva, Pirogov Russian National Research Medical University, Ministry of Health of Russia

ORCID iD: 0000-0002-4540-6341

4 Dolgorukovskaya St., Moscow 127006, Russia

117 Leninskiy Prospekt, Moscow 119571, Russia

1 Ostrovityanova St., Moscow 117997, Russia 

Russian Federation

P. O. Nikiforova

Pirogov National Medical and Surgical Center, Ministry of Health of Russia

Author for correspondence.
Email: pol_nikiforova@mail.ru
ORCID iD: 0000-0001-5046-9016

Polina Olegovna Nikiforova 

70 Nizhnyaya Pervomayskaya St., Moscow 105203, Russia 

Russian Federation

N. R. Rabadanova

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

ORCID iD: 0000-0003-4107-501X

Build. 2, 8 Trubetskaya St., Moscow 119048, Russia 

Russian Federation

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