Original Research Article
Year: 2020 | Month: April-June | Volume: 5 | Issue: 2 | Pages: 199-204
Interval Debulking Surgery (IDS) in Advanced Ovarian Cancer – Immediate Surgical Outcomes and Optimal Cytoreduction Rate
Anuvi1, Ratnesh2, Mahalakshmi Pendurthi1
1Department of OBG, Narayana Health City, Bengaluru, Karnataka, India
2Department of Community Medicine, Dumka Medical College, Dumka, Jharkhand, India
Corresponding Author: Ratnesh
ABSTRACT
Introduction: In Indian women, ovarian cancer is the fourth most common cancer, out of which epithelial ovarian cancers are the most common and present in advanced stage. Women with other comorbidities and those who are unlikely to achieve optimal debulking at primary surgery, benefit from neoadjuvant chemotherapy (NACT) followed by interval cytoreduction, with lesser surgical morbidity and equal survival rates as compared to primary cytoreduction.
Material & methods: A 1 year retrospective study was conducted at tertiary care hospital situated in Bangalore from June 2018 to May 2019. Total 9 study participants who underwent interval debulking surgery following neoadjuvant chemotherapy were included in this study. Data was collected from hospital record using a pre designed questionnaire which had variables like age, stage of ovarian carcinoma at the time of diagnosis, number of NACT cycles that the study subjects underwent , blood loss, volume of residual disease, optimal cytoreduction rate, intraoperative complications and immediate surgical outcomes . Histopathological examination reports were collected and chemotherapy response score, grade and type of tumour were ascertained.
Results: Epithelial cancers constituted 100% (n = 10) of all cases. The mean age of the patients who underwent IDS following NACT was 52.22 ± 5 years ranging from 46 to 62 years. All cases presented at advanced stage with 3 (33.3%) being in Stage IIIb, 4 (44.4%) being in Stage IIIc and 2 (22.2%) being in Stage IV at the time of diagnosis. The median number of NACT cycles (paclitaxel + carboplatin) was 3. Optimal cytoreduction (residual disease <1cm) was achieved in 77.7% cases. The median postoperative stay was 7 days.
Conclusion: High rates of optimal cytoreduction were achieved at interval cytoreductive surgery after NACT with acceptable surgical morbidity.
Keywords: Advanced ovarian cancer, Interval debulking surgery, neoadjuvant chemotherapy, residual disease, optimal cytoreduction