TY - JOUR
T1 - Survival outcome and perioperative complication related to neoadjuvant chemotherapy with carboplatin and paclitaxel for advanced ovarian cancer
T2 - A systematic review and meta-analysis
AU - Machida, Hiroko
AU - Tokunaga, Hideki
AU - Matsuo, Koji
AU - Matsumura, Noriomi
AU - Kobayashi, Yoichi
AU - Tabata, Tsutomu
AU - Kaneuchi, Masanori
AU - Nagase, Satoru
AU - Mikami, Mikio
N1 - Funding Information:
This project was assisted by an Expert Panel of the Japan Society of Gynecologic Oncology, via Medical Information Network Distribution Service which received financial support from the Ministry of Health, Labor and Welfare of Japan as a consignment project.
Funding Information:
This project was assisted by an Expert Panel of the Japan Society of Gynecologic Oncology, via Medical Information Network Distribution Service which received financial support from the Ministry of Health, Labor and Welfare of Japan as a consignment project. Appendix A
Publisher Copyright:
© 2019 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology
PY - 2020/5
Y1 - 2020/5
N2 - Objective: To compare the effectiveness and safety of neoadjuvant chemotherapy with carboplatin/paclitaxel followed by interval debulking surgery (NACT-IDS) to primary debulking surgery plus postoperative chemotherapy (PDS) for advanced ovarian cancer. Methods: A comprehensive systematic review and meta-analysis were conducted by an Expert Panel of the Japan Society of Gynecologic Oncology Ovarian Cancer Committee. Multiple public search engines including PubMed/MEDLINE and the Cochrane Database, were searched in March 2019 using the entry keywords “ovarian cancer [all fields]" AND “interval debulking surgery [all fields]”, AND “neoadjuvant chemotherapy [all fields]”. Key inclusion criteria were prospective clinical trials examining platinum-based NACT for stage II-IV epithelial ovarian cancer. The primary outcome of interest was survival, and the secondary outcome was adverse events with each intervention. Results: After screening 333 studies, four phase III randomized clinical trials were identified that met the inclusion criteria. These trials included 1692 women (847 receiving NACT-IDS and 845 receiving PDS). It was found that NACT-IDS and PDS had similar overall survival (hazard ratio [HR]: 0.97, 95% confidence interval [CI]: 0.87–1.07, P = 0.53) and progression-free survival (HR: 0.98, 95%CI: 0.90–1.08, P = 0.74). In contrast, NACT-IDS was associated with significantly lower rates of perioperative complications (odds ratio [OR] 0.27, 95%CI: 0.20–0.36, P < 0.001) and perioperative mortality (OR: 0.17, 95%CI: 0.06–0.50, P < 0.001) compared to PDS. Conclusion: This systematic review and meta-analysis suggests that NACT-IDS with carboplatin and paclitaxel does not negatively impact the survival of women with advanced ovarian cancer compared to PDS, while perioperative complications and mortality are significantly reduced by 70–80%.
AB - Objective: To compare the effectiveness and safety of neoadjuvant chemotherapy with carboplatin/paclitaxel followed by interval debulking surgery (NACT-IDS) to primary debulking surgery plus postoperative chemotherapy (PDS) for advanced ovarian cancer. Methods: A comprehensive systematic review and meta-analysis were conducted by an Expert Panel of the Japan Society of Gynecologic Oncology Ovarian Cancer Committee. Multiple public search engines including PubMed/MEDLINE and the Cochrane Database, were searched in March 2019 using the entry keywords “ovarian cancer [all fields]" AND “interval debulking surgery [all fields]”, AND “neoadjuvant chemotherapy [all fields]”. Key inclusion criteria were prospective clinical trials examining platinum-based NACT for stage II-IV epithelial ovarian cancer. The primary outcome of interest was survival, and the secondary outcome was adverse events with each intervention. Results: After screening 333 studies, four phase III randomized clinical trials were identified that met the inclusion criteria. These trials included 1692 women (847 receiving NACT-IDS and 845 receiving PDS). It was found that NACT-IDS and PDS had similar overall survival (hazard ratio [HR]: 0.97, 95% confidence interval [CI]: 0.87–1.07, P = 0.53) and progression-free survival (HR: 0.98, 95%CI: 0.90–1.08, P = 0.74). In contrast, NACT-IDS was associated with significantly lower rates of perioperative complications (odds ratio [OR] 0.27, 95%CI: 0.20–0.36, P < 0.001) and perioperative mortality (OR: 0.17, 95%CI: 0.06–0.50, P < 0.001) compared to PDS. Conclusion: This systematic review and meta-analysis suggests that NACT-IDS with carboplatin and paclitaxel does not negatively impact the survival of women with advanced ovarian cancer compared to PDS, while perioperative complications and mortality are significantly reduced by 70–80%.
KW - Meta-analysis
KW - Neoadjuvant chemotherapy
KW - Ovarian cancer
KW - Perioperative complication
KW - Survival
KW - Systematic review
UR - http://www.scopus.com/inward/record.url?scp=85076536066&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85076536066&partnerID=8YFLogxK
U2 - 10.1016/j.ejso.2019.11.520
DO - 10.1016/j.ejso.2019.11.520
M3 - Article
C2 - 31818526
AN - SCOPUS:85076536066
SN - 0748-7983
VL - 46
SP - 868
EP - 875
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 5
ER -
