Prognostic impact of cytoreductive surgery conducted with primary intent, versus cytoreductive surgery after neoadjuvant chemotherapy, in the management of patients with advanced epithelial ovarian cancers: a multicentre, propensity score-matched study from the FRANCOGYN group.

epithelial ovarian cancer interval cytoreductive surgery neoadjuvant chemotherapy primary cytoreductive surgery propensity score

Journal

BJOG : an international journal of obstetrics and gynaecology
ISSN: 1471-0528
Titre abrégé: BJOG
Pays: England
ID NLM: 100935741

Informations de publication

Date de publication:
Nov 2023
Historique:
revised: 05 04 2023
received: 10 02 2023
accepted: 15 04 2023
pubmed: 11 5 2023
medline: 11 5 2023
entrez: 11 5 2023
Statut: ppublish

Résumé

To compare survival and morbidity rates between primary cytoreductive surgery (pCRS) and interval cytoreductive surgery (iCRS) for epithelial ovarian cancer (EOC), using a propensity score. We conducted a propensity score-matched cohort study, using data from the FRANCOGYN cohort. Retrospective, multicentre study of data from patients followed in 15 French department specialized in the treatment of ovarian cancer. Patients included were those with International Federation of Gynaecology and Obstetrics (FIGO) stage III or IV EOC, with peritoneal carcinomatosis, having undergone CRS. The propensity score was designed using pre-therapeutic variables associated with both treatment allocation and overall survival (OS). The primary outcome was OS. Secondary outcomes included recurrence-free survival (RFS), quality of CRS and other variables related to surgical morbidity. A total of 513 patients were included. Among these, 334 could be matched, forming 167 pairs. No difference in OS was found (hazard ratio, HR = 0.8, p = 0.32). There was also no difference in RFS (median = 26 months in both groups) nor in the rate of CRS leaving no macroscopic residual disease (pCRS 85%, iCRS 81.4%, p = 0.76). The rates of gastrointestinal tract resections, stoma, postoperative complications and hospital stay were significantly higher in the pCRS group. Analysis of groups of patients made comparable by propensity score matching showed no difference in survival, but lower postoperative morbidity in patients treated with iCRS.

Identifiants

DOI: 10.1111/1471-0528.17524 PMID: 37165717
pubmed: 37165717
doi: 10.1111/1471-0528.17524
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1511-1520

Informations de copyright

© 2023 John Wiley & Sons Ltd.

Références

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Auteurs

Henri Wohrer (H)

Department of Gynaecological Oncological and Breast Surgery, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France.
ORCID: 0000-0002-3526-5477

Meriem Koual (M)

Department of Gynaecological Oncological and Breast Surgery, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France.
INSERM UMR-S 1124, University of Paris Cité, Centre Universitaire des Saint-Père, Paris, France.

Enrica Bentivegna (E)

Department of Gynaecological Oncological and Breast Surgery, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France.

Louise Benoit (L)

Department of Gynaecological Oncological and Breast Surgery, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France.
INSERM UMR-S 1124, University of Paris Cité, Centre Universitaire des Saint-Père, Paris, France.

Marie Metairie (M)

Department of Gynaecological Oncological and Breast Surgery, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France.

Pierre-Adrien Bolze (PA)

Department of Gynecologic and Oncologic Surgery and Obstetrics, Lyon Sud University Hospital, Hospices Civils de Lyon, Université Lyon 1, Lyon, France.

Yohan Kerbage (Y)

CHU Lille, Service de Chirurgie Gynécologique, Université Lille, Lille, France.

Emilie Raimond (E)

Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France.

Cherif Akladios (C)

Department of Gynaecology, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.

Xavier Carcopino (X)

Department of Obstetrics and Gynaecology, Hôpital Nord, APHM, Aix-Marseille University (AMU), Univ Avignon, CNRS, IRD, IMBE UMR 7263, Marseille, France.

Geoffroy Canlorbe (G)

Department of Gynecological and Breast Surgery and Oncology, Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), University Hospital, Paris, France.
Centre de Recherche Saint-Antoine (CRSA), INSERM UMR_S_938, Cancer Biology and Therapeutics, Sorbonne University, Paris, France.
University Institute of Cancer, Sorbonne University, Paris, France.

Jennifer Uzan (J)

Department of Obstetrics Gynecology and Reproductive Medicine, University Paris Est Créteil, Centre Hospitalier Inter-Communal de Créteil, Creteil, France.

Vincent Lavoue (V)

Service de Gynécologie, INSERM 1242, Oncogenesis, Stress and Signaling, CRLC Eugène Marquis, Université de Rennes 1, Hopital Sud, CHU de Rennes, Rennes, France.

Camille Mimoun (C)

Service de Chirurgie Gynécologique - Université de Paris, Hôpital Lariboisière, Paris, France.

Cyrille Huchon (C)

Service de Chirurgie Gynécologique - Université de Paris, Hôpital Lariboisière, Paris, France.

Martin Koskas (M)

Division of Gynaecologic Oncology, Bichat University Hospital, Paris, France.

Hélène Costaz (H)

Department of Surgical Oncology, Georges-Francois Leclerc Centre, Dijon, France.

François Margueritte (F)

Department of Gynaecology, Centre Hospitalier Intercommunal de Poissy-Saint-Germain-en-Laye Site Hospitalier de Poissy, Poissy, France.

Yohann Dabi (Y)

Department of Gynaecology and Obstetrics, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.

Cyril Touboul (C)

Department of Gynaecology and Obstetrics, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.

Sofiane Bendifallah (S)

Department of Gynaecology and Obstetrics, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.

Lobna Ouldamer (L)

Department of Gynaecology, Hôpital Universitaire de Tours, Tours, France.

Nicolas Delanoy (N)

Institut du Cancer Paris CARPEM, Université de Paris Cité, Paris, France.
Department of Medical Oncology, AP-HP Centre, Hopital Européen Georges Pompidou, Paris, France.

Huyen-Thu Nguyen-Xuan (HT)

Department of Gynaecological Oncological and Breast Surgery, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France.

Anne-Sophie Bats (AS)

Department of Gynaecological Oncological and Breast Surgery, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France.
Institut du Cancer Paris CARPEM, Université de Paris Cité, Paris, France.
INSERM UMR-S 1147, Centre de Recherche des Cordeliers, University of Paris Cité, Paris, France.

Henri Azaïs (H)

Department of Gynaecological Oncological and Breast Surgery, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France.
Institut du Cancer Paris CARPEM, Université de Paris Cité, Paris, France.
INSERM UMR-S 1147, Centre de Recherche des Cordeliers, University of Paris Cité, Paris, France.

Classifications MeSH