Pabina Afroz Parveen
Kurmitola General Hospital, BangladeshTitle: A predictive score after neoadjuvant chemotherapy for optimal cytoreduction at interval debulking surgery in advanced EOC
Abstract
Background: Ovarian cancer is the seventh most common cancer and eighth most common cause of death of female. More than 75% patients diagnosed at Stage (III - IV) and 5-year survival rate is (25- 50%). Primary debulking surgery (PDS) followed by adjuvant chemotherapy is the cornerstone treatment for advanced ovarian cancer. Unfortunately, primary debulking surgery is not always feasible and not associated with optimal cytoreduction. Recently, neoadjuvant chemotherapy followed by Interval Debulking Surgery (NACT- IDS) is increasingly adopted. (NACT-IDS) improves optimal cytoreduction and reduces complications in comparison with PDS. However, a significant proportion of patients cannot be optimally cytoreduced even after NACT-IDS and causes futile laparotomy. So, it is necessary to develop a PSC after NACT for optimal cytoreduction at (IDS).
Objective: To find out a predictive score after NACT) for optimal cytoreduction at IDS in advanced epithelial ovarian cancer.
Method: This was a prospective observational study conducted among 55 patients of advanced ovarian cancer to develop a predictive score after NACT at IDS in department of Gynecological Oncology of BSMMU, from January 2020 to December 2020.
Result: Among the 55 patients with advanced epithelial ovarian cancer 44(80%) could be optimally cytoreduced whereas in 11(20%) suboptimal cytoreduction occurred. The sensitivity, specificity, NPV, PPV and accuracy of CA-125 for prediction of optimal cytoreduction was 87.5%, 30.8%,85.7%,34.1% and 47.3% respectively. It was observed that 37 (84.1%) have peritoneal cancer index within 0-16 in R0 and 3 (27.3%) in non-R0 (p value 0.001). The sensitivity, specificity, NPV, PPV and accuracy of PCI for prediction of optimal cytoreduction was 62.5%, 89.7%, 85.4% 74.1% and 81.8% respectively. PSC after NACT for optimal cytoreduction at (IDS) was 3 and it indicates 83.3%. Patients could be optimally cytoreduced limiting the rate of suboptimal cytoreduction in 16.7%.
Conclusion: The result of the present study showed that PSC after NACT influences Optimal cytoreduction (R <1cm) at (IDS). So, this study concluded that IDS after NACT should be performed in patients with a PSC up to 2 to avoid suboptimal cytoreduction.
Biography
Pabina Afroz Parveen is highly educated and has 20 years of experience medical doctor in Gynecology and Gynecological Oncology. Possesses FCPS (Obst. & Gynae.), FCPS (Gynecological Oncology) and Medical license. Seasoned doctor with a demonstrated record of accomplishments in skilled patient evaluation, diagnostics, and treatment planning to assist patients with controlling symptoms, improving health and making healthier choices in internal concerns such as pregnancy diseases, Ovarian tumors/cancer, etc.
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