Background:Advanced-stage ovarian cancer presents a significant therapeutic challenge, with primary cytoreductive surgery (PCS) followed by chemotherapy and neoadjuvant chemotherapy (NACT) with interval debulking surgery (IDS) as the two main treatment modalities. This study aims to compare the clinical outcomes, surgical complexity, and survival rates between these approaches and to assess the impact of molecular markers such as BRCA and HRD status.Methods:This retrospective, single-center observational study included 100 patients diagnosed with stage III-IV high-grade serous ovarian cancer. The patients were divided into two cohorts based on their treatment strategy: PCS followed by adjuvant chemotherapy or NACT followed by IDS. Clinical outcomes, recurrence-free survival (RFS), progression-free survival (PFS), and overall survival (OS) were analyzed, along with the impact of genetic biomarkers.Results:No statistically significant differences were observed in OS and PFS between the two treatment approaches. Patients who underwent NACT followed by IDS had lower surgical complexity scores and reduced perioperative morbidity. The HRD-positive patients exhibited improved responses to PARP inhibitors, reinforcing the significance of molecular profiling in therapeutic decision-making. The KELIM scores demonstrated prognostic relevance, particularly in the patients receiving neoadjuvant chemotherapy.Conclusion:Both PCS and NACT-IDS are viable treatment options for advanced ovarian cancer, with similar survival outcomes. The choice between strategies should be tailored based on patient-specific factors, including tumor burden, performance status, and molecular profile. The integration of biomarkers such as BRCA mutations and HRD status into clinical practice can further refine treatment selection and improve personalized management strategies.
背景：晚期卵巢癌的治疗面临重大挑战，主要治疗方式包括初次肿瘤细胞减灭术（PCS）联合术后化疗，以及新辅助化疗（NACT）联合间歇性肿瘤细胞减灭术（IDS）。本研究旨在比较这两种治疗方式的临床结局、手术复杂程度及生存率，并评估BRCA和HRD状态等分子标志物的影响。 方法：这项回顾性单中心观察性研究纳入了100例诊断为III-IV期高级别浆液性卵巢癌的患者。根据治疗策略将患者分为两组：PCS联合辅助化疗组或NACT联合IDS组。分析临床结局、无复发生存期（RFS）、无进展生存期（PFS）和总生存期（OS），并评估遗传生物标志物的影响。 结果：两种治疗方式在OS和PFS方面未观察到统计学显著差异。接受NACT联合IDS治疗的患者手术复杂程度评分更低，围手术期并发症发生率更低。HRD阳性患者对PARP抑制剂的反应更佳，这进一步证实了分子分型在治疗决策中的重要性。KELIM评分显示出预后相关性，尤其是在接受新辅助化疗的患者中。 结论：PCS和NACT-IDS均为晚期卵巢癌的有效治疗选择，生存结局相似。策略选择应根据患者个体因素进行调整，包括肿瘤负荷、体能状态和分子特征。将BRCA突变和HRD状态等生物标志物纳入临床实践，可进一步优化治疗选择，改善个体化管理策略。
肿瘤(癌症)患者之家