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SCORPION - Perioperative

Phase III randomised clinical trial comparing primary surgery versus neoadjuvant chemotherapy in advanced epithelial ovarian cancer with high tumour load (SCORPION trial): Final analysis of peri-operative outcome

Date of Publication:

May 1, 2016

Pubmed Link:
https://pubmed.ncbi.nlm.nih.gov/26998845/
Hypothesis:

Is NACT/IDS superior to PDS in patients with high tumor load (HTL) in terms of peri-operative morbidity?

Control Arm(s):

PDS

Carbo AUC 5

Paclitaxel 175 mg/m2

Bevacizumab allowed

q3 wks x6 cycles

Experimental Arm(s):

Carbo AUC 5

Paclitaxel 175 mg/m2

q3wks x3-4 cycles

IDS

Post-operative chemotherapy, for total of 6 cycles

Bevacizumab allowed

Primary End Point:

peri-operative outcome

Inclusion Criteria:

Stage IIIC or IV resectable epithelial ovarian cancer

18- 75 yrs old

Predictive index (PI) score 8-12 (i.e. high tumor load)

Exclusion Criteria:

Mesenteric retraction regardless of PI

Results:

PDS (n=55) vs NACT/IDS (n=55):

CGR: 45.5% vs 57.7% (NS)

Upper abd procedures: 100%  vs 42.3% (SS)

High surgical complexity: 100% vs 48.1% (SS)

OR time: 451 vs 275 min (SS)

G3+ Pleural effusion: 30.9% vs 1.9% (SS)

Grade IV/V early complications in arm A only (SS)

Late post-op grade 3/4: 15.1% vs 0% (SS)

Chemotherapy side effects similar

QOL total scores - Statistically and clinically better in NACT/IDS during treatment, but no differences seen 6 months post-CT

Conclusions:

NACT/IDS is better than PDS in patients with high tumor load advanced stage ovarian cancer in terms of peri-operative morbidity; no difference in QOL at the end of treatment

Reviewer:
Courtney Bailey, OTF