Neoadjuvant Chemotherapy, Case Volume, and Mortality in Advanced Ovarian Cancer

How are neoadjuvant chemotherapy utilization and hospital volume associated with postoperative mortality and overall survival after cytoreductive surgery in advanced-stage ovarian cancer?In this cross-sectional study that included 70 707 patients with stage III or IV ovarian cancer, high utilization of neoadjuvant chemotherapy was associated with a 74% reduction in odds of 90-day mortality in high-volume centers, compared with 52% in low-volume centers. Treatment in high-volume centers with high (compared with low) neoadjuvant chemotherapy use was associated with a 4.0-month improvement in 60-month life expectancy.In this study, treatment for ovarian cancer in high-volume centers with high neoadjuvant chemotherapy use was associated with the lowest 90-day surgical mortality and longest 60-month survival.

Corresponding Author: Alexander Melamed, MD, MPH, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114 (alexander.melamed@mgh.harvard.edu).

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