Neo-adjuvant chemotherapy for advanced stage endometrial carcinoma: a glimmer of hope in select patients

Alex Rabinovich

Research output: Contribution to journalReview articlepeer-review

19 Scopus citations

Abstract

Purpose of review: The objective of this review is to conduct a critical appraisal of the published literature on the use of neo-adjuvant chemotherapy followed by interval debulking in the treatment of stage IVb endometrial carcinoma patients. Methods: Narrative review of the pertinent literature on the application of neo-adjuvant chemotherapy and interval surgery in the treatment of advanced stage endometrial cancers. Results: Advanced stage endometrial carcinoma patients are treated by aggressive cytoreduction followed by adjuvant chemotherapy or by chemotherapy alone. The prognosis of patients that cannot undergo surgery is extremely poor. Preoperative reduction of tumor burden by chemotherapy can facilitate surgery in patients previously considered to have an unresectable disease, identify patients with chemo-sensitive tumors that are more likely to benefit from surgery, and enable a less aggressive surgery thus reducing morbidity. However, only 106 cases of neo-adjuvant chemotherapy were documented in the last two decades, majority (76) were described in retrospective case reports and case series. The available data may indicate feasibility of neo-adjuvant treatment in select patients. Compared to patients that had primary surgery, neo-adjuvant setting was associated with improved or equivalent survival and maximal debulking rates and reduced postoperative morbidity. Conclusions: Until further progress is reached, consideration can be given to recommending neo-adjuvant chemotherapy followed by interval debulking to patients with poor performance status or those patients who the surgeon believes would have suboptimal debulking if surgery was attempted.

Original languageEnglish
Pages (from-to)47-53
Number of pages7
JournalArchives of Gynecology and Obstetrics
Volume293
Issue number1
DOIs
StatePublished - 1 Jan 2016
Externally publishedYes

Keywords

  • Advanced stage endometrial carcinoma
  • Interval debulking
  • Neo-adjuvant chemotherapy

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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