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 - Université de Rennes Accéder directement au contenu
Article Dans Une Revue BJOG: An International Journal of Obstetrics and Gynaecology Année : 2023

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

Henri Wohrer
Enrica Bentivegna
  • Fonction : Auteur
Louise Benoit
  • Fonction : Auteur
Marie Metairie
  • Fonction : Auteur
Pierre-Adrien Bolze
  • Fonction : Auteur
Yohan Kerbage
  • Fonction : Auteur
Emilie Raimond
  • Fonction : Auteur
Cherif Akladios
  • Fonction : Auteur
Jennifer Uzan
  • Fonction : Auteur
Camille Mimoun
  • Fonction : Auteur
Cyrille Huchon
  • Fonction : Auteur
Martin Koskas
  • Fonction : Auteur
Hélène Costaz
  • Fonction : Auteur
François Margueritte
  • Fonction : Auteur
Yohann Dabi
  • Fonction : Auteur
Cyril Touboul
  • Fonction : Auteur
Sofiane Bendifallah
  • Fonction : Auteur
Lobna Ouldamer
  • Fonction : Auteur
Nicolas Delanoy
  • Fonction : Auteur
Huyen-Thu Nguyen-Xuan
  • Fonction : Auteur

Résumé

Objective: 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. Design: We conducted a propensity score-matched cohort study, using data from the FRANCOGYN cohort. Setting: Retrospective, multicentre study of data from patients followed in 15 French department specialized in the treatment of ovarian cancer. Sample: Patients included were those with International Federation of Gynaecology and Obstetrics (FIGO) stage III or IV EOC, with peritoneal carcinomatosis, having undergone CRS. Methods: The propensity score was designed using pre-therapeutic variables associated with both treatment allocation and overall survival (OS). Main outcome measures: The primary outcome was OS. Secondary outcomes included recurrence-free survival (RFS), quality of CRS and other variables related to surgical morbidity. Results: 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. Conclusions: 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.
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Dates et versions

hal-04122121 , version 1 (08-06-2023)

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Henri Wohrer, Meriem Koual, Enrica Bentivegna, Louise Benoit, Marie Metairie, et al.. 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. BJOG: An International Journal of Obstetrics and Gynaecology, 2023, ⟨10.1111/1471-0528.17524⟩. ⟨hal-04122121⟩
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