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Compliance to treatment guidelines and survival in women undergoing interval debulking surgery for advanced epithelial ovarian cancer

In Cancer Reports
By: Shylasree TS [Corresponding Author].
Contributor(s): Kattepur, AK | Gupta M | Ghosh J | Maheshwari A | Bajpai J | Hawaldar R | Gulia S | Deodhar K | Popat P | Gupta S | Kerkar RA.
Material type: materialTypeLabelArticlePublisher: 2019Description: .Subject(s): Advanced epithelial ovarian cancer | Compliance | Deviation | Interval debulking surgery | Survival In: Cancer Reports [Epub ahead of print]Summary: Background:One of the primary treatment strategies for advanced epithelial ovar-ian cancers includes neoadjuvant chemotherapy (NACT) followed by intervaldebulking surgery (IDS) and adjuvant chemotherapy. Compliance to treatment isimportant to possibly improve outcomes.Aim:To audit treatment compliance and its effect on overall survival (OS) and dis-ease free survival (DFS) in women undergoing IDS.Methods and Results:Women diagnosed with advanced epithelial ovarian cancerundergoing IDS were included. Details of compliance to chemotherapy and surgeryas per standard guidelines were assessed, and correlation with survival was studied.Reasons for protocol deviation at various levels were documented and analysed.A total of 182 patients were included. The total number of deviations was 134 withdeviation at any level being 89 (48.9%) and at all levels 5%. Both patient‐andtreatment‐related factors contributed towards deviation. Deviation or noncompliancetowards treatment resulted in a significantly reduced 5‐year OS (34.4% vs 58.2%;P=.001) compared with compliant patients, which retained its significance on multivari-ate analysis (P= .024) as well.Conclusion:Deviation from treatment guidelines resulted in a significantly lower 5‐year OS compared with those who remained treatment compliant. Both patient‐andtreatment‐related factors contributed towards noncompliance and hence towardslower survival.
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Address for Corresponding Author: shylasree@hotmail.com

Background:One of the primary treatment strategies for advanced epithelial ovar-ian cancers includes neoadjuvant chemotherapy (NACT) followed by intervaldebulking surgery (IDS) and adjuvant chemotherapy. Compliance to treatment isimportant to possibly improve outcomes.Aim:To audit treatment compliance and its effect on overall survival (OS) and dis-ease free survival (DFS) in women undergoing IDS.Methods and Results:Women diagnosed with advanced epithelial ovarian cancerundergoing IDS were included. Details of compliance to chemotherapy and surgeryas per standard guidelines were assessed, and correlation with survival was studied.Reasons for protocol deviation at various levels were documented and analysed.A total of 182 patients were included. The total number of deviations was 134 withdeviation at any level being 89 (48.9%) and at all levels 5%. Both patient‐andtreatment‐related factors contributed towards deviation. Deviation or noncompliancetowards treatment resulted in a significantly reduced 5‐year OS (34.4% vs 58.2%;P=.001) compared with compliant patients, which retained its significance on multivari-ate analysis (P= .024) as well.Conclusion:Deviation from treatment guidelines resulted in a significantly lower 5‐year OS compared with those who remained treatment compliant. Both patient‐andtreatment‐related factors contributed towards noncompliance and hence towardslower survival.

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