Neoadjuvant Chemotherapy for Newly Diagnosed, Advanced Ovarian Cancer
Publication Date: August 8, 2016
Key Points
Key Points
- Nearly 75% of women with ovarian cancer are diagnosed with advanced stage disease (International Federation of Gynecology and Obstetrics [FIGO] IIIC or IV) at presentation.
- Recently two randomized clinical trials (RCTs) demonstrated that neoadjuvant chemotherapy (NACT) was noninferior to primary cytoreductive surgery (PCS) with respect to progression-free and overall survival and resulted in a lower incidence of treatment-related morbidity and mortality.
- However, both trials have been criticized because the median overall survival, mean operative time, and rates of optimal cytoreduction were lower than expected.
- This Guideline provides guidance to clinicians regarding the use of neoadjuvant chemotherapy and interval cytoreduction among women with stage IIIC or IV epithelial ovarian cancer.
Assessment
...sessment...
...en with suspected stage IIIC or IV i...
...ry clinical evaluation should includ...
Treatment
...atment...
Table 1. Risk Factors for Perioperati...
Women who have a high perioperative risk...
...isions that women are not eligible f...
...re fit for PCS, with potentially resectable d...
...high likelihood of achieving cytoreduc...
...women who are fit for PCS but are deemed unlikely...
...ACT is delivered, all patients shoul...
...CT, a platinum/taxane doublet is recommended...
...sted surgery following three or four cycles of c...
...ith progressive disease on NACT have a poor progn...
...valuation and Treatment of Women With S...