Abstract

Objective: The aim of this study was to examine the survival and surgical outcomes of women with stage IIIC/IV endometrial cancer who received neoadjuvant chemotherapy followed by delayed primary surgery alongside that of women who underwent primary cytoreductive surgery followed by chemotherapy.
Materials & Methods: In this retrospective review, 44 patients in the time period from 2010 to 2016 were identified from the cancer services database suitable for categorisation into either arm of the study. 16 women received neoadjuvant chemotherapy and their survival outcomes were compared with 28 women who underwent primary surgery. Overall survival and progression-free survival were described using Kaplan Meier survival curves. Intraoperative surgical outcomes and postoperative complications were evaluated in the 2 groups.
Results: Women in both groups were of comparable age, ethnicity and performance status. There was no significant difference in the incidence of both intraoperative complications and postoperative morbidity. Rates of optimal cytoreduction were similar (NACT 69% vs PCS 61%). There was no difference in median progression-free survival, 12 months versus 15 months, NACT vs PCS (p value 0.59). Overall median survival was noted be 33 months in the NACT group versus 27 months in the PCS cohort (p value 0.77).
Conclusion: No significant difference was noted in surgical outcomes between the 2 treatment groups. The usage of NACT in women who were initially deemed inoperable showed survival outcomes that were comparable with that achieved in women undergoing upfront surgery followed by chemotherapy for advanced endometrial cancer.