Comparison of Long-Term Survival Between Primary and Interval Cytoreductive Surgery in Advanced Ovarian Cancer: A Ten-Year Real-World Cohort Study
Menée à partir de données 2013-2024 portant sur 400 patientes atteintes d’un cancer épithélial de l’ovaire de stade FIGO III-IV, cette étude compare la survie sans progression et la survie globale en fonction du traitement : chirurgie de réduction tumorale primaire ou chimiothérapie néoadjuvante suivie d’une chirurgie de réduction tumorale d’intervalle
Objectives: To compare long-term survival outcomes between primary debulking surgery (PDS) and neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS) in patients with advanced ovarian cancer.
Methods: We conducted a retrospective cohort study of 400 patients with FIGO stage III–IV epithelial ovarian cancer between 2013 and 2024. Propensity score matching (PSM) was employed to balance baseline characteristics, resulting in 124 patients in each treatment group. Progression-free survival (PFS) and overall survival (OS) were the primary endpoints.
Results: In the matched cohort, PDS was associated with improved survival outcomes compared to NACT-IDS. Median PFS was 31.6 months for PDS versus 20.17 months for NACT-IDS (HR 0.6503, 95%CI 0.4734–0.8932, P = 0.0071). Median OS was 49.67 months for PDS versus 40.5 months for NACT-IDS (HR 0.6333, 95%CI 0.4425–0.9064, P = 0.0124). In multivariable analysis, NACT-IDS remained independently associated with poorer PFS (adjusted HR 1.59, 95% CI 1.14–2.22; P = 0.006) and OS (adjusted HR 1.62, 95% CI 1.11–2.37; P = 0.013). In the subgroup analysis, CC0/R0 resection was significantly associated with improved survival.
Conclusions: In conclusion, in this single-institution retrospective real-world cohort, PDS was associated with longer PFS and OS than NACT-IDS after adjustment for measured baseline characteristics. Regardless of treatment strategy, CC0/R0 resection was associated with improved survival outcomes, highlighting the importance of individualized treatment selection aimed at achieving safe complete cytoreduction whenever feasible.
European Journal of Surgical Oncology , résumé, 2026