Comparison of cytoreductive surgery after neoadjuvant chemotherapy with primary cytoreductive surgery in epithelial ovarian cancer

Objective: The most common type of ovarian cancer is epithelial ovarian cancer. Majority of patients are diagnosed in advanced stages. Primary treatment approach is surgery in epithelial ovarian cancer. It is aimed to provide sufficient surgery, to reduce blood loss during operation, to minimize complications, reduce hospital stay and to improve the quality of life of patients with chemotherapy before surgery. In this study, it has been compared patient undergone preoperative chemotherapy with the results of patients who had direct surgery.Material and Method: Patients with Stage IIIC and IV who undergone an operation because of epithelial ovarian cancer were retrospectively assessed between the years 2006-2009. The patients who underwent cytoreductive surgery after neoadjuvant chemotherapy were assessed as group 1 and the patients who underwent primary cytoreductive surgery were assessed as group 2. Duration of surgery, practicability of adequate surgery, complications during and after surgery, intraoperative blood transfusion requirements, duration of hospital stay, and average survival time were compared between groups. The value of p was taken <0,05 for the statistical significance level among results.Results: Group 1 consists of 30 patients, group 2 consists of 28 patients. Whereas optimal cytoreductive rate is 80% in group 1, this rate was found as 67,9 % in second group (p=0.373). Duration of surgery was found as average 122,3 minutes in group 1, it was found as average 151,3 minutes in group 2 (p=0.001). Intraoperative complications were not developed in both groups. Blood transfusion was made to 39,7 of patients in group 1 and to 78,6% of patiens in group 2 (p=0.008). Whereas duration of hospital stay was found as average 8,6 days in group 1, it was found as average 11,3 days in group 2 (p=0.08). The postoperative complications and intensive care were not developed in group 1 patients. The postoperative complication was developed at the rate of 14,3% and intensive care was developed at the rate of 14,3 % in group 2 patients. Average survival time was found as 37,5 months in group 1 patients, it was found as 35,4 months in group 2 patients (p=0.791).Conclusion: Duration of surgery of patients, the blood transfusion, and duration of hospital stay of patients were statistically decreased with neoadjuvant chemotherapy at significant level. In both groups of patients, surgical competence and the average survival time were increased who underwent cytoreductive surgery after neoadjuvant chemotherapy, but this difference was not statistically significant.Keywords: Epithelial ovarian cancer, neoadjuvant chemotherapy, cytoreductive surgery, complication.