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Does Modality of Adjuvant Chemotherapy After Interval Surgical Debulking Matter in Epithelial Ovarian Cancer?: An Exploratory Analysis

Al Mutairi, Nashmia Joudallah MD; Le, Tien MD

International Journal of Gynecological Cancer: March 2014 - Volume 24 - Issue 3 - p 461–467
doi: 10.1097/IGC.0000000000000066
Ovarian Cancer

Objectives: This article aimed to study the role of adjuvant intraperitoneal (IP) chemotherapy after neoadjuvant chemotherapy and optimal interval surgical debulking.

Method: All patients with epithelial ovarian cancer treated with neoadjuvant chemotherapy were retrospectively reviewed from 2007 to 2009. Demographics, related diseases, and survival outcome data were abstracted from the medical records. χ2 statistics were applied to categorical variables. Cox regression was used to model progression-free survival (PFS), adjusting for age, residual status, and use of adjuvant IP chemotherapy. All P values less than 0.05 were considered statistically significant.

Results: Sixty-five patients were reviewed. The median age was 63.3 years. The majority had stage III disease with serous histology. Optimal residual (<1 cm) after interval debulking was achieved in 34 (54%) of 63 patients. Sixteen patients chose to receive adjuvant IP chemotherapy. The median follow-up was 26.2 months. Fifty-one patients had progressed, with a median PFS of 17.5 months. Adjuvant IP chemotherapy was not predictive of PFS (hazard ratio, 0.91; 95% confidence interval [CI], 0.24–3.44; P = 0.89). The estimated median overall survival was 37.8 months (95% CI, 29.9–45.7) in the intravenous group versus 48.1 months (95% CI, 37.9–58.3) in the IP-treated patients (P = 0.162).

Conclusions: Adjuvant IP chemotherapy was not predictive of survival after neoadjuvant chemotherapy in our small exploratory study. The role of IP chemotherapy in this setting needs to be further studied in a larger prospective patient cohort.

Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Newborn Care, University of Ottawa, Ottawa, Ontario, Canada.

Address correspondence and reprint requests to Nashmia Joudallah Al Mutairi, MD, Division of Gynecologic Oncology, Ottawa General Hospital, 501 Smyth Rd—Room 8130, Ottawa, Ontario, Canada K1H 8L6. E-mail:;

The research project was funded by an educational research grant from Roche Pharmaceuticals.

The authors declare no conflicts of interest.

Received June 5, 2013

Accepted November 17, 2013

© 2014 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.