Evaluation of the neo-adjuvant chemotherapy by intra-operative mapping of ovarian tumour during interval cytoreductive surgery in epithelial ovarian cancer

Abstract

Background: Epithelial ovarian cancer usually presents at an advanced stage and neoadjuvant chemotherapy followed by interval cytoreduction is a standard treatment procedure. Visual intraoperative impression of the extent of the disease, total disease burden and resection status at the end of the cytoreductive surgery are important prognostic factors. Systematic documentation of the operative findings forms the cornerstone of an oncology center. Methods: A prospective observational study was carried out to carry out intra-operative mapping of ovarian cancer at the time of interval cytoreduction after a course of 3-4 cycles of neo-adjuvant chemotherapy. Results: 110 patients were included in the study. Profile of the patient were documented in the study along with the operative findings. It has evolved as a clinical and surgical audit of our center. Maximum tumour burden was evident in omentum (37.2%), followed by ovaries (11.8%) and deposits in pouch of douglas (7.2%). Notably, in 64.5% cases there was complete resection followed by R1 (residual disease status up to 1 cm) in 22.7% cases and R2 (residual disease status more than 1 cm) in 12.7% cases. In 43.6% there was complete remission of the disease with no evidence of the disease on histopathological examination.