ArticleAmerican journal of cancer research2026
Survival outcomes, treatment response, and prognostic factors of different treatment modalities in patients with epithelial ovarian cancer: a retrospective cohort study.
Article in American journal of cancer research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Epithelial ovarian cancer (EOC) is commonly diagnosed at an advanced stage; however, the optimal upfront treatment - primary debulking surgery (PDS) versus neoadjuvant chemotherapy followed by interval debulking surgery (NACT+IDS) - remains controversial. This single-center retrospective cohort study used propensity score matching (PSM) to compare overall survival (OS), progression-free survival (PFS), surgical outcomes, tumor response, and safety between PDS and NACT+IDS in 197 EOC patients treated between March 2022 and April 2024, with follow-up censored in April 2026. After 1:1 PSM, 80 matched pairs were analyzed. Compared with the PDS group, the NACT+IDS group demonstrated significantly shorter operative time, less blood loss, a higher R0 resection rate, fewer ICU admissions, and a lower incidence of severe complications within 30 days after surgery (all P<0.05). The NACT+IDS group also had higher overall response and disease control rates (both P<0.05), whereas the incidence of grade ≥3 chemotherapy-related adverse events was comparable between groups (P=0.500). PFS and OS did not differ significantly between the two cohorts (P=0.795 and P=0.062, respectively), and treatment modality was not independently associated with either endpoint in multivariable Cox regression analyses. Poor tumor differentiation and residual lesion >1 cm were independently associated with shorter PFS, whereas FIGO stage IV disease, poor tumor differentiation, and residual lesion >1 cm were independently associated with shorter OS. Subgroup analyses suggested potential differences according to histological subtype; however, these findings were exploratory due to limited sample size. In conclusion, PDS and NACT+IDS offer comparable survival outcomes in patients with advanced EOC, whereas NACT+IDS is associated with improved perioperative safety and higher tumor response rates without increasing severe chemotherapy-related toxicity. Treatment decisions should be individualized according to tumor biology, resectability, and patient characteristics rather than based on a uniform treatment strategy. These findings warrant confirmation in larger prospective studies.
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