Women with advanced ovarian cancer who have chemotherapy before surgery suffered fewer side effects and tended to have a better quality of life than those following the traditional strategy of surgery first, a Cancer Research UK study has found.
In the CHORUS trial, carried out at the Medical Research Council Clinical Trials Unit at University College London and published in The Lancet, 276 women were given the standard treatment of surgery followed by six cycles of chemotherapy, while 274 had surgery after three cycles of chemo.
Post-surgery complications and death within 28 days of surgery was most common among women given surgery first. Those who underwent surgery after chemo “suffered fewer symptoms, a reduction in overall side effects and had a lower death rate,” the researchers said.
Of those having surgery first, 231 died with an average survival of 22.6 months, compared to 220 deaths in the primary chemotherapy group with an average survival of 24.1 months.
Also, delaying surgery cut the amount of time the patient spent in the hospital after surgery, with 80% receiving primary surgery discharged within 14 days versus against 93% after delayed surgery, offering a benefit to both the patient and NHS resources.
“Whether to have chemotherapy before major surgery for ovarian cancer has always been a dilemma for women and their surgeons,” said Professor Peter Johnson, chief clinician at CR UK. “Thanks to this study we can say that having chemotherapy first makes the surgery safer, the stay in hospital shorter and women's quality of life better”.