Table 1.
Summary of RCTs comparing NACT to pTRS in advanced epithelial ovarian cancer.
| Author | [20] | [21] # | [17] | [18] | ||||
|---|---|---|---|---|---|---|---|---|
| Year | 2020 | 2016 | 2015 | 2010 | ||||
| Enrolled cases | NACT | pTRS | NACT | pTRS | NACT | pTRS | NACT | pTRS |
| 149 | 152 | 55 | 55 | 274 | 276 | 334 | 336 | |
| Stage IV | 49 (32.9) | 47 (30.9) | 4 (7.3) | 8 (14.5) | 68 (24.8) | 70 (25.4) | 81 (24.3) | 77 (22.9) |
| PS 0–1 | 131 (86.2) | 130 (87.2) | 50 (90.9) | 51 (92.7) | 221 (80.7) | 221 (80.1) | 290 (86.8) | 294 (87.5) |
| PS ≥ 2 | 21 (13.8) | 19 (12.8) | 5 (9.1) | 4 (7.3) | 53 (19.3) | 54 (19.6) | 44 (13.2) | 40 (11.9) |
| Surgical time (mins) | 302 | 240 | 275 | 451 | 120 | 120 | 180 | 165 |
| R0 ‡ | 83 (63.8) | 17 (11.6) | 30 (57.7) | 25 (45.5) | 79 (39.3) | 39 (16.7) | 151 (51.2) | 61 (19.4) |
| Periop mortality | 0 | 1 (0.7) | 0 | 2 (3.6) | 1 (0.5) | 14 (5.5) | 2 (0.7) | 8 (2.5) |
| G3-4 AE | 7 (5.4) | 25 (17.0) | 3 (5.8) | 27 (49.1) | 30 (14) | 60 (24) | 17 (5.3) * | 56 (18.1) * |
| DFS | HR 0.96 (0.75–1.23) | HR 1.06 (0.77–1.46) † | HR 0.91 (0.76–1.09) | HR 1.01 (0.89–1.15) ¶ | ||||
| OS | HR 1.05 (0.84–1.33) § | - | - | HR 0.87 (0.72–1.05) | HR 0.98 (0.84–1.13) ¶ | |||
| Subgroup analysis of overall survival in the NACT group as compared with the pTRS group | ||||||||
| Age > 70 | - | - | - | - | Comparable | - | Comparable | - |
| PS ≥ 2 | Comparable | - | - | - | Comparable | - | Comparable | - |
| Stage IIIC | Comparable | - | - | - | Comparable | - | Comparable | - |
| Stage IV | Comparable | - | - | - | Comparable | - | NACT better | - |
| CSS | - | - | - | - | - | - | - | - |
| Other cause of death | - | - | - | - | - | - | - | - |
| Non-serous $ | Comparable | - | - | - | - | - | Comparable | - |
| R0 | - | - | - | - | Comparable | - | Comparable | - |
Adopted and modified from the author’s own work [11]; Gynecol. Oncol. 2021, 160, 32–39. Matsuo, K., et al. Possible candidate population for neoadjuvant chemotherapy in women with advanced ovarian cancer. Copyright (2021) with permission from Elsevier. Summary of randomized control trials comparing NACT to pTRS in advanced epithelial ovarian cancer. Number (percentage per column) of hazard ratio (95%CI) is shown. # women with predictive index >8 or <12 were included. * included hemorrhage, infection and venous complication. † this result was reported in 2018. ‡ no macroscopic residual disease. $ indicates mucinous carcinoma and clear cell carcinoma. § this study could not confirm the noninferior OS of NACT. ¶ 90% confidence interval. The 95%CI overlaps 1 and the upper bound of the 95% CI exceeds the predetermined non-inferior margin (1.161). Abbreviations: RCT, randomized controlled trial; NACT, neoadjuvant chemotherapy; pTRS, primary cytoreductive surgery; Op, operation; G3 or G4, grade 3 or grade 4; AE, adverse event; DFS, disease free survival; OS, overall survival; CSS, cause specific survival; -, not applicable; HR, hazard ratio; and CI, confidence interval.