Earlier is not always better: Optimal time to initiate adjuvant chemotherapy after surgery for ovarian cancer
Standard treatment of ovarian cancer includes chemo after surgery, either with or without neoadjuvant chemo beforehand. There has always been an imperative to begin chemo as soon as possible, hoping to reduce the risk of recurrence.
For some women with ovarian cancer, it is not possible to start chemo early. Either because of debility infection or circumstance. This study looks at outcomes for women who start chemo late and compares them to other women whose chemo is not delayed.
The retrospective study looked at the outcomes of 1700 women who had surgery for ovarian cancer at 5 German Hospitals during the period 2020-2021. They were divided into 3 groups; those who had chemo early (less than 3 weeks post-surgery), intermediate (3-5 weeks post-surgery), and late (greater than 5 weeks). The outcomes measured were progress free survival (PFS),
and overall survival (OS).
Results from this study showed both early and late groups had worse OS than those women who started their chemo in the intermediate time frame of 3-5 weeks post-surgery. Previous studies have shown more post-op complications for the early group and women who start chemo late often have more complex disease. Of interest is that PFS was similar for all 3 groups. The authors suggest that women whose chemo is delayed can be reassured that the delay will not cause immediate harm.